Restall, Gayle; Strutt, Carolyn
The participation of people who use mental health services in service planning and evaluation has become increasingly important in recent years. Health planners and people who use services are seeking information about how to enable participation that is meaningful and impacts positively on service delivery. This qualitative study explored the perspectives of people who use mental health services on participation in mental health service planning and evaluation. Sixty-three people from diverse backgrounds participated in either a focus group or interview. Themes were extracted from the data and resulted in a conceptual framework that can be used to guide the development and evaluation of participation.
Roussy, Véronique; Livingstone, Charles
Until now, comprehensive service planning has been uncommon in the Victorian community health sector. Where it has occurred, it has primarily been undertaken by community health services embedded within larger, hospital-based health services. Reflections on the utility and efficacy of community health service planning are largely absent from the Australian peer-reviewed literature. Using a case study focussed on a specific centre in Melbourne's outer suburbs, this paper explores how community health service planning is shaped by the current policy context, the legal status of registered community health services, and the data and methodologies available to inform planning. It argues that regular and systematic service planning could support registered community health centres to better understand their unique position within the primary health-care landscape, having regard to their inherent opportunities and vulnerabilities. Furthermore, consistent and effective service planning is proposed to benefit agencies in establishing themselves as critical players in promoting local population health initiatives and driving improved health outcomes.
A recent Population Council publication, Reproductive Health Approach to Family Planning, discusses integration of reproductive health into family planning programs in a series of edited presentations that Council staff and colleagues gave at a 1994 meeting of the US Agency for International Development (USAID) cooperating agencies. The presentations reflect the Council's view that family planning programs ought to help individuals achieve their own reproductive goals in a healthful manner. The report discusses four areas of reproductive health: reproductive tract infections (RTIs), including sexually transmitted diseases; prevention and treatment of unsafe abortion; pregnancy, labor, and delivery care; and postpartum care. Christopher Elias (Senior Associate, Programs Division) argued that family planning programs ought to provide services that target RTIs, given that these illnesses afflict a significant proportion of reproductive-age women. The family planning community has an ethical responsibility to provide services to women who experience an unwanted pregnancy. They must have access to high-quality postabortion care, including family planning services. Professional midwives are ideally suited to serve as integrated reproductive health workers trained to combat the five major maternal killers: hemorrhage, sepsis, pregnancy-induced hypertension, obstructed labor, and unsafe abortion. This was demonstrated in a highly successful Life-Saving Skills for Midwives program undertaken in Ghana, Nigeria, and Uganda, and soon to start in Vietnam in conjunction with the Council's Safe Motherhood research program. Family planning services should be viewed as part of a comprehensive set of health services needed by postpartum women, which include appropriate contraception, maternal health checks, well-baby care, and information about breastfeeding, infant care, and nutrition. Family planning programs should incorporate breastfeeding counseling into their services. When
Niniek Lely Pratiwi
Full Text Available Background: The MDG target to increase maternal health will be achieved when 50% of maternal deaths can be prevented through improvment the coverage of K1, K4, to make sure that midwife stay in the village improve the delivery by health workers in health facilities, increase coverage long-term contraceptive methods participant as well as family and community empowerment in health. Methods: This study is a further analysis of Riskesdas in 2010 to assess how big the accessibility of services in family planning in Indonesia. Results: Women of 3–4 children in rural greater and prevalence (27.1% compared to women who live in urban areas (25.0%. The main reason of not using contraception mostly because they want to have children 27.0% in urban, 28.2% rural whereas, the second reason is the fear of side effects 23.1% in urban, 16.5% rural. There is 10% of respondent did not use contraceptives, because they did not need it. Health seeking behavior of pregnant women with family planning work status has a significant relationship (prevalence ratio 1.073. The jobless mothers has better access to family planning services compared to working mother. Conclusions: Accessibility of family planning services is inadequate, because not all rural ‘Poskesdes’ equipped with infrastructure and family planning devices, a lack of knowledge of family planning in rural areas. Health seeking behavior of family planning services is mostly to the midwives, the scond is to community health centers and than polindes, ‘poskesdes’ as the ranks third.
Full Text Available The integration of marketing in the field of health care, starting with the 50’s, was accompanied by a series of controversies generated by the ethical and moral aspects that this type of services imply, as well as by the difficulty in determining exactly the demand, the unequal access to information of participants, the regulated mechanism for the establishment of prices and of rates and the intervention of the third party payer, the significant role of the state in ensuring the fair access of population to basic services, etc.The formulation of the marketing strategies, in the marketing planning process, starts from the generic strategy chosen by the organization according to its mission and objectives. As it has to adapt to the environment where it acts, to cope with the changes that appear, the organization must benefit from a perspective vision, all its actions must be subordinated to this vision in a whole marketing policy.
...-AQ07 Group Health Plans and Health Insurance Issuers Relating to Coverage of Preventive Services Under... group health plans and health insurance coverage in the group and individual markets under provisions of... to group health plans and group health insurance issuers on August 1, 2011. ADDRESSES: Written...
Department of Health and Children
Workforce planning identifies the composition of the workforce required to deliver health service goals. It encompasses a range of human resource activities aimed at the short, medium and long-term. Workforce planning that is integrated with service and financial planning offers the best opportunity for linking human resource decisions to the strategic goals for the health services. Systems and structures are required to support and develop workforce planning activities
Nyonator, Frank K; Awoonor-Williams, J Koku; Phillips, James F; Jones, Tanya C; Miller, Robert A
Research projects demonstrating ways to improve health services often fail to have an impact on what national health programmes actually do. An approach to evidence-based policy development has been launched in Ghana which bridges the gap between research and programme implementation. After nearly two decades of national debate and investigation into appropriate strategies for service delivery at the periphery, the Community-based Health Planning and Services (CHPS) Initiative has employed strategies tested in the successful Navrongo experiment to guide national health reforms that mobilize volunteerism, resources and cultural institutions for supporting community-based primary health care. Over a 2-year period, 104 out of the 110 districts in Ghana started CHPS. This paper reviews the development of the CHPS initiative, describes the processes of implementation and relates the initiative to the principles of scaling up organizational change which it embraces. Evidence from the national monitoring and evaluation programme provides insights into CHPS' success and identifies constraints on future progress.
McGrail, Matthew R; Russell, Deborah J; Humphreys, John S
Objective Improving access to primary health care (PHC) remains a key issue for rural residents and health service planners. This study aims to show that how access to PHC services is measured has important implications for rural health service and workforce planning.Methods A more sophisticated tool to measure access to PHC services is proposed, which can help health service planners overcome the shortcomings of existing measures and long-standing access barriers to PHC. Critically, the proposed Index of Access captures key components of access and uses a floating catchment approach to better define service areas and population accessibility levels. Moreover, as demonstrated through a case study, the Index of Access enables modelling of the effects of workforce supply variations.Results Hypothetical increases in supply are modelled for a range of regional centres, medium and small rural towns, with resulting changes of access scores valuable to informing health service and workforce planning decisions.Conclusions The availability and application of a specific 'fit-for-purpose' access measure enables a more accurate empirical basis for service planning and allocation of health resources. This measure has great potential for improved identification of PHC access inequities and guiding redistribution of PHC services to correct such inequities.What is known about the topic? Resource allocation and health service planning decisions for rural and remote health settings are currently based on either simple measures of access (e.g. provider-to-population ratios) or proxy measures of access (e.g. standard geographical classifications). Both approaches have substantial limitations for informing rural health service planning and decision making.What does this paper add? The adoption of a new improved tool to measure access to PHC services, the Index of Access, is proposed to assist health service and workforce planning. Its usefulness for health service planning is
Kalina, C M; Fitko, J
1. The occupational health nurse is often mandated by management to validate health services offered and programs developed for employees as valuable to the business and company mission. 2. The business plan of the occupational health service is a working document, changing as needs of the client/customer and internal and external business and socio-economic environment evolve. 3. Alignment with and support of the company mission, goals, and objectives is another method of proving good occupational health is good business. 4. Business planning is a basic business tool the wise and prudent occupational health nurse can use in proving good occupational health is vital to the success of a company.
Lima, Sheyla Maria Lemos; Portela, Margareth Crisóstomo; Ugá, Maria Alicia Domíngues; de Vasconcellos, Maurício Teixeira Leite
This paper characterizes regulatory procedures applied by private health plan operators on their outpatient radiotherapy and chemotherapy services, especially via contracts, and outlines the health care providers’ perception on regulation. The study relied on primary data, taking into consideration 638 hospitals and outpatient health care units with the services in question. A stratified random sample was selected, resulting in the inclusion of 54 units that are representative of the population, excluding hospitals that only provide radiotherapy. Private chemotherapy services are largely funded by health insurance plans (75.0%), while radiotherapy services are predominantly covered by the public health system (49.0%). Contracts are not applied by third part payers, in their potential, as regulatory and health care coordination instruments. The mechanisms of regulation applied by third part payers are centered on services use control and administrative aspects. It is recognized the need of adjustments for a health care quality focus, and contracts may contribute in this sense.
Jacobson, Nora; Greenley, Dianne; Breedlove, Lynn; Roschke, Ruth; Koberstein, Jen
This brief report describes a participatory evaluation and planning process--a "guided reflection"--that mental health services agencies can use to examine the state of recovery awareness and implementation in their organizations. The process revolves around structured small group discussions, identification of agency strengths and weaknesses, and the formation of an agency "recovery action team" to set priorities and plan for change.
Panzera, Annette June; Murray, Richard; Stewart, Ruth; Mills, Jane; Beaton, Neil; Larkins, Sarah
Creating a stable and sustainable health workforce in regional, rural and remote Australia has long been a challenge to health workforce planners, policy makers and researchers alike. Traditional health workforce planning is often reactive and assumes continuation of current patterns of healthcare utilisation. This demonstration project in Far North Queensland exemplifies how participatory regional health workforce planning processes can accurately model current and projected local workforce requirements. The recent establishment of Primary Health Networks (PHNs) with the intent to commission health services tailored to individual healthcare needs underlines the relevance of such an approach. This study used action research methodology informed by World Health Organization (WHO) systems thinking. Four cyclical stages of health workforce planning were followed: needs assessment; health service model redesign; skills-set assessment and workforce redesign; and development of a workforce and training plan. This study demonstrated that needs-based loco-regional health workforce planning can be achieved successfully through participatory processes with stakeholders. Stronger health systems and workforce training solutions were delivered by facilitating linkages and planning processes based on community need involving healthcare professionals across all disciplines and sectors. By focusing upon extending competencies and skills sets, local health professionals form a stable and sustainable local workforce. Concrete examples of initiatives generated from this process include developing a chronic disease inter-professional teaching clinic in a rural town and renal dialysis being delivered locally to an Aboriginal community. The growing trend of policy makers decentralising health funding, planning and accountability and rising health system costs increase the future utility of this approach. This type of planning can also assist the new PHNs to commission health services
Aicken Catherine R H
Full Text Available Abstract Background Decision Analytic Models (DAMs are established means of evidence-synthesis to differentiate between health interventions. They have mainly been used to inform clinical decisions and health technology assessment at the national level, yet could also inform local health service planning. For this, a DAM must take into account the needs of the local population, but also the needs of those planning its services. Drawing on our experiences from stakeholder consultations, where we presented the potential utility of a DAM for planning local health services for sexually transmitted infections (STIs in the UK, and the evidence it could use to inform decisions regarding different combinations of service provision, in terms of their costs, cost-effectiveness, and public health outcomes, we discuss the barriers perceived by stakeholders to the use of DAMs to inform service planning for local populations, including (1 a tension between individual and population perspectives; (2 reductionism; and (3 a lack of transparency regarding models, their assumptions, and the motivations of those generating models. Discussion Technological advances, including improvements in computing capability, are facilitating the development and use of models such as DAMs for health service planning. However, given the current scepticism among many stakeholders, encouraging informed critique and promoting trust in models to aid health service planning is vital, for example by making available and explicit the methods and assumptions underlying each model, associated limitations, and the process of validation. This can be achieved by consultation and training with the intended users, and by allowing access to the workings of the models, and their underlying assumptions (e.g. via the internet, to show how they actually work. Summary Constructive discussion and education will help build a consensus on the purposes of STI services, the need for service planning to
Smith, Marie A; Spiggle, Susan; McConnell, Brody
Health plans are moving away from a volume-driven payment structure toward value-driven and risk-based contracts. There is very limited information on commercial payers' perspectives on coverage of medication management services (MMS) in value-based alternative payment models. While some health plans have experience with Medicare Part D Medication Therapy Management (MTM) programs, this experience does not promote the integration of pharmacists as health care team members. The study objectives were to: (1) understand the evaluation process that health plan executives would use to determine benefit coverage for pharmacist-provided MMS in value-based health plans, (2) identify the facilitators and barriers that affect pharmacist-provided MTM services at the community pharmacy level, and (3) propose strategies for pharmacist-provided MMS in value-based health plans. This study used qualitative research methods that involved structured key informant interviews with commercial health plan executives and focus groups with community pharmacists who had experience providing MTM services. Health plan executives agreed conceptually that MMS could be a valuable program and recognized its potential. However, the most substantial barriers that health plan executives expressed were funding MMS in today's fee-for-service payment models; lack of physician infrastructure to implement and manage MMS; and difficulty in collecting timely, accurate data to execute and assess MMS programs. Community pharmacists identified the most serious barrier to altering health outcomes through MTM as the current lack of integration of MTM with a coordinated health care team. MTM services are conducted as a separate program by pharmacists who do not have access to patient health records, are time-constrained, and poorly incentivized. The findings can inform the development of successful strategies for pharmacist-provided MMS that align with emerging value-based health plans and alternative provider
Caramanica, L; Maxwell, S; Curry, S
A new process for business planning at Hartford Hospital was needed to achieve critical business results. This article describes the Hospital's use of the Malcolm Baldrige Performance Excellence Criteria as a way to standardize and improve business planning. Women's Health Services is one of Hartford Hospital's "centers for excellence" and one of the first to use these criteria to improve its service. Staff learned how to build their business plan upon a set of core values and concepts such as customer-driven quality, leadership that sets high expectations, continuous improvement and learning, valuing employees, faster response to market demands, management by fact, and a long-range view of the future.
... hospital services must include short-term rehabilitation services and physical therapy, the provision of... hospitalization; (13) Whole blood and blood plasma; (14) Long-term physical therapy and rehabilitation; (15....101 Section 417.101 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND...
Karmel, Tom; Blomberg, Davinia
This paper aims to provide a picture of the occupations in the community services and health industry, and how the workforce obtains the required skills. The authors argue that planning for the industry should concentrate on occupations specific to the industry and those which require high skill levels. Findings suggest that the qualification…
A review of the experience of adolescent reproductive health clinics in Liverpool and Bristol highlights the potentially disruptive impact of new National Health Service (NHS) policies and competing professional interests on the attempt to provide integrated, high-quality services. In particular, responsiveness to client needs often collides with NHS demands for efficiency. UK health authorities accept, in principle, the need for separate, informal family planning centers for young people. The 34 Brook Advisory Centers, which deliver confidential contraceptive and counseling services to adolescents, face pressure to become population rather than client-based and to reduce time spent on individual sessions. Moreover, new NHS contracting arrangements have greatly increased the role of general practitioners (GPs) in contraceptive provision, with serious implications for family planning clinics. At present, about 70% of UK women obtain contraceptive and sexual health services from a GP. This encroachment has further increased the marginalization of family planning practitioners, the majority of whom are female, within the medical profession. Concerns have been expressed, however, that GPs are not able to offer the comprehensive services available in clinics and lack sufficient female staff.
Singh, Karun Krishna
This research investigated the question: What is the impact of strategic planning process variation on superior organizational performance in nonprofit human service organizations providing mental health services? The study employed a retrospective, cross-sectional, comparison group design using a combination of survey data, unobtrusive agency backup data, and follow-up in-person interview data. The sample was comprised of two main groups of organizations, those that were doing strategic planning and those that were not engaged in strategic planning. Responses were obtained from the chief executive officers of 306 of the 380 randomly selected organizations resulting in a response rate of 81%. Hypotheses were tested using multiple and logistic regression procedures. The major finding of this study was that complete strategic planning is highly correlated with superior organizational performance. The implications of the findings for administration, policy, research, and the social work profession are discussed.
Mathur, Medha; Goyal, Ram Chandra; Mathur, Navgeet
Quality of sterilization services is a matter of concern in India because population control is a necessity. Family Planning Sterilization (FPS) services provided at public health care facilities need to be as per Standard Operating Procedures. To assess the quality of FPS services by audit of case records at selected health care facilities. This cross-sectional study was conducted for two and a half year duration at selected public health care facilities of central India by simple random sampling where FPS services were provided. As per the standards of Government of India, case records were audited and compliance was calculated to assess the quality of services. Results of record audit were satisfactory but important criteria like previous contraceptive history and postoperative counselling were found to be deviated from standards. At Primary Health Centres (PHCs) only 89.5% and at Community Health Centres (CHCs) 58.7% of records were having details of previous contraceptive history. Other criteria like mental illness (only 70% at CHCs) assessment were also inadequate. Although informed consent was found to be having 100% compliance in all records. Quality of care in FPS services is the matter of concern in present scenario for better quality of services. This study may enlighten the policy makers regarding improvements needed for providing quality care.
Maryland State Dept. of Education, Baltimore.
This guide for Maryland schools outlines the role of school health services and proper facility design for these services. Chapter 1 provides an overview, describing coordinated school health programs, school health services programs, school health services programs in Maryland, how school health services are delivered, trends, the number of…
Nian CUI; Min-xiang LI; Xiao-wen TU
Objective To understand the reproductive health needs of unmarried youth so as to provide them better quality services.Method Data were drawn from a baseline questionnaire survey of provision of reproductive health information and services for unmarried youth aged 16-20 years in rural areas of Chengdu, Southwest China in 2001-2002.Results The study comprised of 1 895 valid subjects. More than 70% subjects felt that the knowledge, information and services in relation to sexual and reproductive health provided by the society were rather insufficient. Near 95% thought that unmarried young people seeking sexual and reproductive health counseling and services were quite normal, although some of them had different misgivings. Their preferred services in reproductive health included: counseling in relation to sexual and reproductive health, how to cope with unexpected sex and unwanted pregnancy, how to select the appropriate contraceptives for unmarried youth, etc. About 2/3 subjects agreed to provide contraceptive services to unmarried youth actively by the society. And they thought the difficulties and obstacles in provision of contraceptive services for unmarried youth were in the following order: restriction of the traditional conceptions,shyness of unmarried youth in accept of such services, disapproval of parents/school teachers, and so forth.Conclusion To improve reproductive health status of unmarried youth and meet their needs is a challenge to quality service of family planning/reproductive health program in China. The related departments and service providers should pay attention to this matter and take the strategies and measures to provide appropriate, specific, friendly and accessibly services for unmarried young people.
1986), and Zikmund & D’Amico (1986). All four marketing scholars, including Kotler (1984), reference to Philip Kotler’s selected component format (see...motivate both negative and positive behavior in publics can be considered a critical factor in health care service delivery ( Kotler , & Clarke, 1987...monitoring of communicated information is the institution of a marketing plan within the organization ( Kotler & Clarke, 1987). MARKETING Within the
Katibeh, Marzieh; Blanchet, Karl; Akbarian, Shadi; Hosseini, Sara; Ahmadieh, Hamid; Burton, Matthew J
A recent survey of avoidable blindness in Varamin District, Iran, identified moderately high levels of visual impairment (10%) and blindness (1.5%) in people >50 years. This study aimed to define current provision, identify gaps and suggest practical solutions for improving eye health services in this area. The World Health Organization (WHO) framework for analyzing health systems has several key components: service delivery, health workforce, information system, medical products and technologies, financing, and governance. We used this structure to investigate the strengths and weaknesses of the eye health system in Varamin. All public and private eye care facilities and a random selection of primary health care (PHC) units were assessed using semi-structured researcher-administered questionnaires. Varamin has 16 ophthalmic clinics, including two secondary hospitals that provide cataract surgery. There were ten ophthalmologists (1:68,000 population), two ophthalmic nurses and five optometrists working in Varamin district. There were no eye care social or community workers, ophthalmic counsellors, low vision rehabilitation staff. Although the Vision 2020 target for ophthalmologists has been met, numbers of other eye care staff were insufficient. The majority of patients travel to Tehran for surgery. The recent survey identified cataract as the leading cause of blindness, despite the availability of surgical services in the district and high health insurance coverage. Poor awareness is a major barrier. No units had a written blindness prevention plan, formal referral pathways or sufficient eye health promotion activities. Only one of the PHC units referred people with diabetes for retinal examination. There is partial integration between eye care services and the general health system particularly for prevention of childhood blindness: chemo-prophylaxis for ophthalmia neonatorum, school vision tests, measles immunization and Vitamin A supplementation. This analysis
Objective 10 B. Study Methodology 10 IV. E 7SS/HSA LINKAGE TO CIVIL DEFEN SE 13 V. HEALTH AND MEDICAL PLANNING FUNCIONS 31 A. Primarily Non-Health...Department Responsibilities 31 B. Primarily Health Department Responsibilities 41 VI. DISASTER MEDICAL PLANNING IN THE SAN FRANCISCO BAY AREA 62 VII...Agency B-i APPENDIX C - State Emergency Health Service Planning Functions: Potential Agency Input C-i APPENDIX D - San Francisco Bay Area Planning D
Bennett, A R
Advances the case for the use of one particular business planning technique within a National Health Service Trust. At the present time, NHS trusts are required to write strategic direction statements. Evidence suggests that these documents provide an accurate account of past performance and present position of the trust, but do not express the future position intended to be achieved. These documents also tend to be lengthy and lack strategic focus, which means that they are not helpful to managers who want clear organizational goals and objectives to which to work. Attempts to address the difficulties associated with determining how existing skills and resources can be used as the platform for future growth strategies by using the Ansoff Matrix and SWOT Analysis planning tools, given the external changes in the marketplace. Also attempts to shed light on some of the important links between busines strategy and management development by extending planning theory into practice.
Gagliardi, Anna R; Webster, Fiona; Brouwers, Melissa C; Baxter, Nancy N; Finelli, Antonio; Gallinger, Steven
Collaboration among researchers (clinician, non-clinician) and decision makers (managers, policy-makers, clinicians), referred to as integrated knowledge translation (IKT), enhances the relevance and use of research, leading to improved decision-making, policies, practice, and health care outcomes. However IKT is not widely practiced due to numerous challenges. This research explored how context influenced IKT as a means of identifying how IKT could be strengthened. This research investigated IKT in three health services programs for colon cancer screening, prostate cancer diagnosis, and the treatment of pancreatic cancer. Qualitative methods were used to explore contextual factors that influenced how IKT occurred, and its impact. Data were collected between September 1, 2012 and May 15, 2013 from relevant documents, observation of meetings, and interviews with researchers and decision-makers, analyzed using qualitative methods, and integrated. Data were analyzed from 39 documents, observation of 6 meetings, and 36 interviews. IKT included interaction at meetings, joint undertaking of research, and development of guidelines. IKT was most prevalent in one program with leadership, clear goals, dedicated funding and other infrastructural resources, and an embedded researcher responsible for, and actively engaged in IKT. This program achieved a variety of social, research and health service outcomes despite mixed individual views about the value of IKT and the absence of a programmatic culture of IKT. Participants noted numerous challenges including lack of time and incentives, and recommendations to support IKT. A conceptual framework of factors that influence IKT and associated outcomes was generated, and can be used by others to plan or evaluate IKT. The findings can be applied by researchers, clinicians, managers or policy-makers to plan or improve collaborative decision-making for health services planning, delivery, evaluation or quality improvement. Further
This issue of Population Briefs contains articles on researches conducted by the Population Council concerning the delivery of quality of care, contraceptive development, safe abortion, family planning, demography, and medical anthropology. The cover story focuses on a systematic data collection tool called Situation Analysis that helps managers in program evaluation. This tool has a handbook entitled "The Situation Analysis Approach to Assessing Family Planning and Reproductive Health Services" that contains all the information needed to conduct a Situation Analysis study. The second article reports about a new contraceptive method, the two-rod levonorgestrel, which was developed at the Population Council and was recently approved by the US Food and Drug Administration. The third article reports on a medical abortion procedure that was proven to be safe, effective, and acceptable to women in developing countries. Moreover, the fourth article presents initial findings of the Community Health and Family Planning Project conducted in Northern Ghana. The fifth article discusses the paper written by the Population Council demographer, Mark Montgomery entitled "Learning and lags in mortality perceptions". Finally, the sixth article deals with another paper that reports on women's health perceptions and reproductive health in the Middle East.
Polo, Gina; Acosta, C Mera; Ferreira, Fernando; Dias, Ricardo Augusto
This study integrated accessibility and location-allocation models in geographic information systems as a proposed strategy to improve the spatial planning of public health services. To estimate the spatial accessibility, we modified the two-step floating catchment area (2SFCA) model with a different impedance function, a Gaussian weight for competition among service sites, a friction coefficient, distances along a street network based on the Dijkstra's algorithm and by performing a vectorial analysis. To check the accuracy of the strategy, we used the data from the public sterilization program for the dogs and cats of Bogot´a, Colombia. Since the proposed strategy is independent of the service, it could also be applied to any other public intervention when the capacity of the service is known. The results of the accessibility model were consistent with the sterilization program data, revealing that the western, central and northern zones are the most isolated areas under the sterilization program. Spatial accessibility improvement was sought by relocating the sterilization sites using the maximum coverage with finite demand and the p-median models. The relocation proposed by the maximum coverage model more effectively maximized the spatial accessibility to the sterilization service given the non-uniform distribution of the populations of dogs and cats throughout the city. The implementation of the proposed strategy would provide direct benefits by improving the effectiveness of different public health interventions and the use of financial and human resources.
Full Text Available This study integrated accessibility and location-allocation models in geographic information systems as a proposed strategy to improve the spatial planning of public health services. To estimate the spatial accessibility, we modified the two-step floating catchment area (2SFCA model with a different impedance function, a Gaussian weight for competition among service sites, a friction coefficient, distances along a street network based on the Dijkstra's algorithm and by performing a vectorial analysis. To check the accuracy of the strategy, we used the data from the public sterilization program for the dogs and cats of Bogot´a, Colombia. Since the proposed strategy is independent of the service, it could also be applied to any other public intervention when the capacity of the service is known. The results of the accessibility model were consistent with the sterilization program data, revealing that the western, central and northern zones are the most isolated areas under the sterilization program. Spatial accessibility improvement was sought by relocating the sterilization sites using the maximum coverage with finite demand and the p-median models. The relocation proposed by the maximum coverage model more effectively maximized the spatial accessibility to the sterilization service given the non-uniform distribution of the populations of dogs and cats throughout the city. The implementation of the proposed strategy would provide direct benefits by improving the effectiveness of different public health interventions and the use of financial and human resources.
Park, Min Hae; Nguyen, Thang Huu; Ngo, Thoai Dinh
This study describes the dynamics of intrauterine device (IUD) use in Vietnam and implications for family planning services. A retrospective study was conducted among women who received IUD services in 2006-2009 at six commune health stations in three provinces. Women were interviewed about IUD use and switching behaviors. Of 1316 participants, 12.1% had discontinued IUD use at 12 months after insertion, 19.4% at 24 months, and 26.9% at 36 months. The highest rates of discontinuation were among older women and farmers/manual workers. Among 434 women who had an IUD removed, 49% cited health concerns as the main reason. Following removal, 70% switched to another contraceptive method (n = 306); of these, 15% switched to withdrawal, and 12% waited >2 months before adopting a new method. Dissatisfaction with IUD services was associated with high rates of discontinuation. Early discontinuation, delays in adopting new methods, and switching to withdrawal may contribute to unintended pregnancy among commune health station users in Vietnam.
INTRODUCTION: The National Health Service (NHS) Cancer Plan guidelines recommend a maximum 2-week wait from referral to first appointment, and 2 months from referral to treatment for primary cancers. However, there are currently no guidelines available for metastatic disease. In the UK, nearly half of all colorectal cancer patients develop hepatic metastases. Timely, surgical resection offers the potential for cure. The aim of this study was to audit current practice for colorectal liver metastases in a regional hepatobiliary unit, and compare this to the NHS Cancer Plan standards for primary disease. PATIENTS AND METHODS: A retrospective review of the unit\\'s database was performed for all hepatic metastases referrals from January 2006 to December 2008. The dates of referral, first appointment, investigations and initiation of treatment, along with patient\\'s age and sex, were recorded on Microsoft Excel and analysed. Time was expressed as mean +\\/- SD in days. RESULTS: A total of 102 patients with hepatic metastases were identified. Five were excluded due to incomplete data. The average time from referral to first appointment was 10.6 +\\/- 9.4 days and the average time from referral to treatment was 38.5 +\\/- 28.6 days. Seventy-five (72.7%) had surgical intervention, of whom 37 also had chemotherapy. CONCLUSIONS: The data compare favourably to the NHS Cancer Plan guidelines for primary malignancy, demonstrating that a regional hepatobiliary unit is capable of delivering a service for colorectal liver metastases that adheres to the NHS Cancer Plan. Therefore, the NHS Cancer Plan can be applied to this cohort.
Full Text Available Abstract Background Comprehensive studies of family planning (FP in refugee camps are relatively uncommon. This paper examines gender and age differences in family planning knowledge, attitudes, and practices among Sierra Leonean and Liberian refugees living in Guinea. Methods In 1999, a cross-sectional survey was conducted of 889 reproductive-age men and women refugees from 48 camps served by the refugee-organised Reproductive Health Group (RHG. Sampling was multi-stage with data collected for socio-demographics, family planning, sexual health, and antenatal care. Statistics were calculated for selected indicators. Results Women knew more about FP, although men's education reduced this difference. RHG facilitators were the primary source of reproductive health information for all respondents. However, more men then women obtained information from non-health sources, such as friends and media. Approval of FP was high, significantly higher in women than in men (90% vs. 70%. However, more than 40% reported not having discussed FP with their partner. Perceived service quality was an important determinant in choosing where to get contraceptives. Contraceptive use in the camps served by RHG was much higher than typical for either refugees' country of origin or the host country (17% vs. 3.9 and 4.1% respectively, but the risk of unwanted pregnancy remained considerable (69%. Conclusion This refugee self-help model appeared largely effective and could be considered for reproductive health needs in similar settings. Having any formal education appeared a major determinant of FP knowledge for men, while this was less noticeable for women. Thus, FP communication strategies for refugees should consider gender-specific messages and channels.
U.S. Department of Health & Human Services — QHP Landscape Files present basic information about certified Qualified Health Plans and Stand-alone Dental Plans for individuals-families and small businesses...
This paper describes that the nurses attitudes, using and motivation towards the computer usage significantly influenced by area of nursing/health care service. Today most of the nurses traditionally document patient information in a medical record using pen and paper. Most nursing administrators not currently involved with computer applications in their settings are interested in exploring whether technology could help them with the day-to-day and long - range tasks of planning and evaluating nursing services. The results of this investigation showed that respondents (nurses), as specialists and nursing informatics, make their activity well: they had "positive" attitude towards computers and "good" or "average" computer skills. The nurses overall computer attitude did influence by the age of the nurses, by sex, by professional qualification. Younger nurses acquire informatics skills while in nursing school and are more accepting of computer advancements. The knowledge about computer among nurses who don't have any training in computers' significantly differs, who have training and using the computer once a week or everyday. In the health care services often are using the computers and the automated data systems, data for the statistical information (visit information, patient information) and billing information. In nursing field often automated data systems are using for statistical information, billing information, information about the vaccination, patient assessment and patient classification.
Small, Nicola; Brooks, Helen; Grundy, Andrew; Pedley, Rebecca; Gibbons, Chris; Lovell, Karina; Bee, Penny
People with severe mental illness suffer more physical comorbidity than the general population, which can require a tailored approach to physical health care discussions within mental health care planning. Although evidence pertaining to service user and carer involvement in mental health care planning is accumulating, current understanding of how physical health is prioritised within this framework is limited. Understanding stakeholder experiences of physical health discussions within mental health care planning, and the key domains that underpin this phenomena is essential to improve quality of care. Our study aimed to explore service user, carer and professional experiences of and preferences for service user and carer involvement in physical health discussions within mental health care planning, and develop a conceptual framework of effective user-led involvement in this aspect of service provision. Six focus groups and four telephone interviews were carried out with twelve service users, nine carers, three service users with a dual service user and carer role, and ten mental health professionals recruited from one mental health Trust in the United Kingdom. Data was analysed utilising a thematic approach, analysed separately for each stakeholder group, and combined to aid comparisons. No service users or carers recalled being explicitly involved in physical health discussions within mental health care planning. Six prerequisites for effective service user and carer involvement in physical care planning were identified. Three themes confirmed general mental health care planning requirements: tailoring a collaborative working relationship, maintaining a trusting relationship with a professional, and having access to and being able to edit a living document. Three themes were novel to feeling involved in physical health care planning discussions: valuing physical health equally with mental health; experiencing coordination of care between physical-mental health
Full Text Available Background: Since 1994 formal health plans have been used for coordination of health care services between the regional and local level in Denmark. From 2007 a substantial reform has changed the administrative boundaries of the system and a new tool for coordination has been introduced. Purpose: To assess the use of the pre-reform health plans as a tool for strengthening coordination, quality and preventive efforts between the regional and local level of health care. Methods: A survey addressed to: all counties (n=15, all municipalities (n=271 and a randomised selected sample of general practitioners (n=700. Results: The stakeholders at the administrative level agree that health plans have not been effective as a tool for coordination. The development of health plans are dominated by the regional level. At the functional level 27 percent of the general practitioners are not familiar with health plans. Among those familiar with health plans 61 percent report that health plans influence their work to only a lesser degree or not at all. Conclusion: Joint health planning is needed to achieve coordination of care. Efforts must be made to overcome barriers hampering efficient whole system planning. Active policies emphasising the necessity of health planning, despite involved cost, are warranted to insure delivery of care that benefits the health of the population.
Does the design and implementation of proven innovations for delivering basic primary health care services in rural communities fit the urban setting: the case of Ghana's Community-based Health Planning and Services (CHPS)
Adongo, Philip Baba; Phillips, James F; Aikins, Moses; Arhin, Doris Afua; Schmitt, Margaret; Nwameme, Adanna U; Tabong, Philip Teg-Nefaah; Binka, Fred N
.... To help ameliorate this situation, an innovative urban primary health system was introduced in urban Ghana, based on the milestones model developed with the rural Community-Based Health Planning and Services (CHPS) system...
Al-Sawai, Abdulaziz; Al-Shishtawy, Moeness M.
In most countries, the lack of explicit health workforce planning has resulted in imbalances that threaten the capacity of healthcare systems to attain their objectives. This has directed attention towards the prospect of developing healthcare systems that are more responsive to the needs and expectations of the population by providing health planners with a systematic method to effectively manage human resources in this sector. This review analyses various approaches to health workforce planning and presents the Six-Step Methodology to Integrated Workforce Planning which highlights essential elements in workforce planning to ensure the quality of services. The purpose, scope and ownership of the approach is defined. Furthermore, developing an action plan for managing a health workforce is emphasised and a reviewing and monitoring process to guide corrective actions is suggested. PMID:25685381
U.S. Department of Health & Human Services — This locator tool will help you find Title X family planning centers that provide high quality and cost-effective family planning and related preventive health...
Full Text Available Poor adherence is one of the main causes of unintended pregnancies among women of reproductive age. The purpose of this study was to establish the predictors of contraceptive adherence. A total of 211 women were enrolled and interviewed while seeking family planning services at reproductive health Uganda facility. Binary logistic regression was used to analyze the association between adherence and the independent variables. Most of the respondents (83.4% were currently using a hormonal contraceptive. Of the participants who were using contraceptives, 43% had discontinued use at some time for reasons other than pregnancy, 53.1% reported having short birth interval less than 2 years, and 7% reported having more children than desired. The predictors of poor contraceptive adherence included lower education level (OR 2.484, 95% CI 1.403–4.397 and lower self-efficacy (OR 1.698, 95% CI 1.959–3.004. Lack of male partner support (OR 2.014, 95% CI 1.140–3.557 and low education level (OR 2.103, 95% CI 1.196–3.699 were predictive of reporting short birth interval less than 2 years. The findings point to a number of predictors of contraceptive adherence that may have implications for designing and evaluating family planning programs. In the Ugandan context, studies to evaluate effective adherence improvement strategies are needed.
Lee, Yong Yi; Meurk, Carla S; Harris, Meredith G; Diminic, Sandra; Scheurer, Roman W; Whiteford, Harvey A
Ensuring that a mental health system provides 'value for money' requires policy makers to allocate resources to the most cost-effective interventions. Organizing cost-effective interventions into a service delivery framework will require a concept that can guide the mapping of evidence regarding disorder-level interventions to aggregations of services that are meaningful for policy makers. The 'service platform' is an emerging concept that could be used to this end, however no explicit definition currently exists in the literature. The aim of this study was to develop a service platform definition that is consistent with how policy makers conceptualize the major elements of the mental health service system and to test the validity and utility of this definition through consultation with mental health policy makers. We derived a provisional definition informed by existing literature and consultation with experienced mental health researchers. Using a modified Delphi method, we obtained feedback from nine Australian policy makers. Respondents provided written answers to a questionnaire eliciting their views on the acceptability, comprehensibility and usefulness of a service platform definition which was subject to qualitative analysis. Overall, respondents understood the definition and found it both acceptable and useful, subject to certain conditions. They also provided suggestions for its improvement. Our findings suggest that the service platform concept could be a useful way of aggregating mental health services as a means for presenting priority setting evidence to policy makers in mental health. However, further development and testing of the concept is required.
Yong Yi Lee
Full Text Available Ensuring that a mental health system provides ‘value for money’ requires policy makers to allocate resources to the most cost-effective interventions. Organizing cost-effective interventions into a service delivery framework will require a concept that can guide the mapping of evidence regarding disorder-level interventions to aggregations of services that are meaningful for policy makers. The ‘service platform’ is an emerging concept that could be used to this end, however no explicit definition currently exists in the literature. The aim of this study was to develop a service platform definition that is consistent with how policy makers conceptualize the major elements of the mental health service system and to test the validity and utility of this definition through consultation with mental health policy makers. We derived a provisional definition informed by existing literature and consultation with experienced mental health researchers. Using a modified Delphi method, we obtained feedback from nine Australian policy makers. Respondents provided written answers to a questionnaire eliciting their views on the acceptability, comprehensibility and usefulness of a service platform definition which was subject to qualitative analysis. Overall, respondents understood the definition and found it both acceptable and useful, subject to certain conditions. They also provided suggestions for its improvement. Our findings suggest that the service platform concept could be a useful way of aggregating mental health services as a means for presenting priority setting evidence to policy makers in mental health. However, further development and testing of the concept is required.
Brijnath, Bianca; Ansariadi; de Souza, Dziedzom K
Focusing specifically on infectious diseases in low-income countries, this paper discusses four ways Geographic Information Systems (GIS) can facilitate health service planning and delivery: (1) deeper insight into where health care services should be located; (2) improved health surveillance and real-time planning for disease control and population health; (3) stronger accountability and evidence-informed dialogue between funders and the service providers and; (4) greater opportunities to translate complex data into more accessible formats which policymakers can quickly interpret and act on. Taking its use beyond just a research instrument, GIS is a way to undertake multidisciplinary work and improve health service planning and delivery.
Borrell, Luisa N; Northridge, Mary E; Miller, Douglas B; Golembeski, Cynthia A; Spielman, Seth E; Sclar, Elliott D; Lamster, Ira B
The purpose of this paper was to examine the geographic distribution of New York City adults aged 65 and older by race/ethnicity and poverty status. Also analyzed was seniors' access to dental care as defined by the location of dental providers and their proximity to the subway system lines in Manhattan and the Bronx. ArcGIS software was used to create a geographic information system (GIS) incorporating relevant data from a variety of sources. Individual and overlay maps were then produced to examine the aims of this analysis. Data showed that Black race, Hispanic ethnicity, and poverty status tend to co-occur spatially among seniors in Northern Manhattan and the South Bronx. Further, a spatial/transportation barrier may inhibit access to dental care for seniors who reside in these areas. By presenting multiple layers of local information juxtaposed, GIS can help provide directions for planning oral health service delivery for seniors.
Journal of American College Health, 2011
This document, written collaboratively by members of ACHA's Emerging Public Health Threats and Emergency Response Coalition and Campus Safety and Violence Coalition, is designed to assist members of the college health community in planning for emergencies using an all-hazards approach. Its perspective is both macro and micro, beginning with a…
Ramani, K V
Governments all over the world are getting increasingly concerned about their ability to meet their social obligations in the health sector. In this paper, we discuss the design and development of a management information system (MIS) to plan and monitor the delivery of healthcare services in government hospitals in India. Our MIS design is based on an understanding of the working of several municipal, district, and state government hospitals. In order to understand the magnitude and complexity of various issues faced by the government hospitals, we analyze the working of three large tertiary care hospitals administered by the Ahmedabad Municipal Corporation. The hospital managers are very concerned about the lack of hospital infrastructure and resources to provide a satisfactory level of service. Equally concerned are the government administrators who have limited financial resources to offer healthcare services at subsidized rates. A comprehensive hospital MIS is thus necessary to plan and monitor the delivery of hospital services efficiently and effectively.
... page: //medlineplus.gov/ency/patientinstructions/000879.htm Understanding health insurance plans To use the sharing features on this ... plan for you and your family. Types of Health Insurance Plans Depending on how you get your health ...
Bundy, K L; Foss, M L; Stubbs, J R
The Mayo Clinic, in Rochester, Minnesota, recently set forth a directive to develop a Mayo Emergency Incident Command System (MEICS) plan to respond to major disasters. The MEICS plan that was developed interfaces with national response plans to ensure effective communication and coordination between our institution and local, state, and federal agencies to establish a common language and communication structure. The MEICS plan addresses multiple aspects of dealing with resource needs during a crisis, including the need for blood and transfusion medicine services. The MEICS plan was developed to supplement our current local emergency preparedness procedures and provide a mechanism for responding to the escalating severity of an emergency to deal with situations of a magnitude that is outside the normal experience. A plan was developed to interface the existing Transfusion Medicine disaster plan standard operating procedures (SOP) with the institutional and Department of Laboratory Medicine (DLMP) MEICS plans. The first step in developing this interface was defining MEICS. Other major steps were defining the chain of command, developing a method for visually indicating who is "in charge," planning communication, defining the actions to be taken, assessing resource needs, developing flowcharts and updating SOPs, and developing a blood rationing team to deal with anticipated blood shortages. Several key features of the interface and updated disaster plan that were developed are calling trees for response personnel, plans for relocating leadership to alternative command centers, and action sheets to assist with resource assessment. The action sheets also provide documentation of key actions by response personnel.
Full Text Available Background: Uttar Pradesh (UP is the most populous state in India. The maternal mortality ratio, infant mortality rate, and fertility rates are all higher than the national average. Sixty percent of UP inhabitants live in rural communities. The reasons behind the poor state of health and services in many areas of UP are inadequate knowledge and availability in communities of healthy behaviors, and information on available government health services. Methods: World Vision, Inc. implemented a three-and-half year mobilizing plan for maternal and neonatal health through a birth spacing and advocacy project (MOMENT, partnering with local organizations in rural Hardoi and urban slums of Lucknow districts in UP. World Vision used print, audio, visual media, and house-to-house contacts to educate communities on timing and spacing of pregnancies; and the benefits of seeking and using maternal and child health services (MCH including immunization and family planning (FP.This paper focuses on World Vision’s social accountability strategy – Citizen Voice and Action (CVA and interface meetings – used in Hardoi that helped educate and empower Village Health Sanitation and Nutrition Committees (VHSNCs and village leaders to access government untied funds to improve community social and health services. Results: Forty VHSNCs were revived in 24 months. Nine local leaders accessed government untied funds. In addition, increased knowledge of the benefits of timing and spacing of pregnancies, maternal child health, family planning services, and access to community entitlements led the community to embrace and contribute their time to rebuild and re-open 17 non-functional Auxiliary Nurse Midwife (ANM sub-centers. Seventeen ANMs received refresher training to provide quality care. Sub-center data showed that 1,121 and 3,156 women opted for intra-uterine contraceptive device and oral pills, respectively, and 29,316 condoms were distributed. Conclusion: In Hardoi
Oladipo, Jimoh Ayanda
Disparities in use of healthcare services between rural and urban areas have been empirically attributed to several factors. This study explores the existence of this disparity and its implication for planning and managing healthcare delivery systems. The objectives determine the relative importance of the various predisposing, enabling, need and health services factors on utilization of health services; similarity between rural and urban areas; and major explanatory variables for utilization. A four-stage model of service utilization was constructed with 31 variables under appropriate model components. Data is collected using cross-sectional sample survey of 1086 potential health services consumers in selected health facilities and resident milieu via questionnaire. Data is analyzed using factor analysis and cross tabulation. The 4-stage model is validated for the aggregate data and data for the rural areas with 3-stage model for urban areas. The order of importance of the factors is need, enabling, predisposing and health services. 11 variables are found to be powerful predictors of utilization. Planning of different categories of health care facilities in different locations should be based on utilization rates while proper management of established facilities should aim to improve health seeking behavior of people.
O'Brien-Pallas, Linda; Birch, Stephen; Baumann, Andrea; Murphy, Gail Tomblin
The feasibility of integrated health human resources planning (IHHRP) was examined. The analysis focused on the following topics: ways of integrating labor market indicators into service planning; whether planning is sufficiently responsive and flexible to retain relevance and validity in rapidly changing health systems; different models and…
..., ``Clinical Preventive Services for Women, Closing the Gaps,'' women experiencing an unintended pregnancy may... motivated to discontinue behaviors that pose pregnancy-related risks (e.g., smoking, consumption of alcohol... with pregnancies that were planned.\\6\\ Contraceptives also have medical benefits for women who...
Dworsky, Amy; Ahrens, Kym; Courtney, Mark
This research uses data from a longitudinal study to examine how two provisions in the Patient Protection and Affordable Care Act could affect health insurance coverage among young women who have aged out of foster care. It also explores how allowing young people to remain in foster care until age twenty-one affects their health insurance coverage, use of family planning services, and information about birth control. We find that young women are more likely to have health insurance if they remain in foster care until their twenty-first birthday and that having health insurance is associated with an increase in the likelihood of receiving family planning services. Our results also suggest that many young women who would otherwise lack health insurance after aging out of foster care will be eligible for Medicaid under the health care reform law. Because having health insurance is associated with use of family planning services, this increase in Medicaid eligibility may result in fewer unintended pregnancies among this high-risk population. PMID:23262773
Full Text Available Abstract Background Service franchising is a business model that involves building a network of outlets (franchisees that are locally owned, but act in coordinated manner with the guidance of a central headquarters (franchisor. The franchisor maintains quality standards, provides managerial training, conducts centralized purchasing and promotes a common brand. Research indicates that franchising private reproductive health and family planning (RHFP services in developing countries improves quality and utilization. However, there is very little evidence that franchising improves RHFP services delivered through community-based public health clinics. This study evaluates behavioral outcomes associated with a new approach - the Government Social Franchise (GSF model - developed to improve RHFP service quality and capacity in Vietnam's commune health stations (CHSs. Methods The project involved networking and branding 36 commune health station (CHS clinics in two central provinces of Da Nang and Khanh Hoa, Vietnam. A quasi-experimental design with 36 control CHSs assessed GSF model effects on client use as measured by: 1 clinic-reported client volume; 2 the proportion of self-reported RHFP service users at participating CHS clinics over the total sample of respondents; and 3 self-reported RHFP service use frequency. Monthly clinic records were analyzed. In addition, household surveys of 1,181 CHS users and potential users were conducted prior to launch and then 6 and 12 months after implementing the GSF network. Regression analyses controlled for baseline differences between intervention and control groups. Results CHS franchise membership was significantly associated with a 40% plus increase in clinic-reported client volumes for both reproductive and general health services. A 45% increase in clinic-reported family planning service clients related to GSF membership was marginally significant (p = 0.05. Self-reported frequency of RHFP service use
Farrokh-Eslamlou, Hamidreza; Aghlmand, Siamak; Eslami, Mohammad; Homer, Caroline S E
We investigated whether use of the World Health Organization's (WHO's) Decision-Making Tool (DMT) for Family Planning Clients and Providers would improve the process and outcome quality indicators of family planning (FP) services in Iran. The DMT was adapted for the Iranian setting. The study evaluated 24 FP quality key indicators grouped into two main areas, namely process and outcome. The tool was implemented in 52 urban and rural public health facilities in four selected and representative provinces of Iran. A pre-post methodology was undertaken to examine whether use of the tool improved the quality of FP services and client satisfaction with the services. Quantitative data were collected through observations of counselling and exit interviews with clients using structured questionnaires. Different numbers of FP clients were recruited during the baseline and the post-intervention rounds (n=448 vs 547, respectively). The DMT improved many client-provider interaction indicators, including verbal and non-verbal communication (p<0.05). The tool also impacted positively on the client's choice of contraceptive method, providers' technical competence, and quality of information provided to clients (p<0.05). Use of the tool improved the clients' satisfaction with FP services (from 72% to 99%; p<0.05). The adapted WHO's DMT has the potential to improve the quality of FP services.
Bohon, Lisa M; Cotter, Kelly A; Kravitz, Richard L; Cello, Philip C; Fernandez Y Garcia, Erik
Between 9.5% and 31.3% of college students suffer from depression (American college health association national college health assessment II: reference group executive summary spring 2013. Amer. Coll. Health Assoc. 2013; Eagan K, Stolzenberg EB, Ramirez JJ, Aragon, MC, Suchard, RS, Hurtado S. The American freshman: national norms fall 2014. Higher Educ. Res. Inst.; 2015). Universities need to understand the factors that relate to care-seeking behavior. Across 3 studies, to relate attitudes, social norms, and perceived behavioral control to intention to seek mental health services, and to investigate barriers to care-seeking. University college students (N = 845, 64% female, 26% male, and 10% unspecified). New measures were created in Studies 1 and 2, and were examined using structural equation modeling in Study 3. Partially consistent with the Theory of Planned Behavior (Ajzen, I, Fishbein, M. Understanding Attitudes and Predicting Social Behavior. Englewood Cliffs, NJ: Prentice-Hall; 1980), a model with an excellent fit revealed that more positive attitudes about care and higher perceived behavioral control directly predicted higher intention to seek mental health services. Educating college students about mental health disorders and treatments, enhancing knowledge about available services, and addressing limited access to long-term care might improve treatment rates for students suffering from depression.
Naccarella, Lucio; Greenstock, Louise; Wraight, Brenda
To ensure New Zealand's health workforce was fit for purpose, Health Workforce New Zealand (HWNZ) funded Workforce Service Reviews (WSRs) to develop visions for service reconfiguration and workforce for 2020. This paper describes what makes the WSR processes work, for whom, and in what circumstances. Semi-structured interviews informed by a realist evaluation approach were conducted to obtain perceptions and experiences of WSR participants from four WSRs: eye health, palliative care, anaesthesia and aged care. The WSR process was a successful means of bringing together professionals from across the health disciplines and building sector capacity to develop new ways of thinking about service and workforce planning. WSRs were constrained by: mixed signals about process and outcomes; being challenged not milestone focussed; lacking clarity about ownership of visions; and variable clarity about next steps. WSRs were optimised by having: a lead clinician with policy know-how, ability to inspire, bring people together, distil ideas into coherent frameworks; and a project manager with project enablement skill sets and expertise in complex systems, implementation, change management. Evidence now exists at a point in time about what makes the WSR processes work. Implications for HWNZ are presented using a capacity-building framework to inform future decision making regarding WSRs. WHAT IS KNOWN ABOUT THE TOPIC? More appropriate workforce planning is required to meet the challenges facing the health workforce, from both the demand and the workforce side. To ensure New Zealand's healthcare workforce was fit for purpose, HWNZ initiated an iterative WSR process in topic specific areas. The WSRs process was designed to develop a vision of the relevant health service and workforce for 2020, and models of care that were patient-centred and team-based. WHAT DOES THIS PAPER ADD? The paper provides evidence that the WSR process was a successful means for bringing together
Adaptation of Impact Questions from an Existing Toolkit Provided Clear Assessment of Valued Service Elements and Desirable Service Improvements in a Primary Health Care Library and Information Service. A Review of: Urquhart, C., Thomas, R., Ovens, J., Lucking, W., & Villa, J. (2010). Planning changes to health library services on the basis of impact assessment. Health Information and Libraries Journal, 27(4), 277-285. doi: 10.1111/j.1471-1842.2010.00900.x
Objective – To provide an action plan for the Knowledge, Resource and Information Service (KRIS) based on an impact assessment of current services, satisfaction with current services, and views on desirable improvements to service and service delivery.Design – Questionnaire for KRIS service users and interviews with KRIS staff.Setting – Two locations served by KRIS in the north and south of Bristol City in the UK – one a health promotion service and one a National Health Service (NHS) teachin...
Fusté, Josep; Frigola, David; Olivet, Miquel
To apply planning criteria on a territorial level, with a forward-looking approach and taking into account the specificities of each location, in the Health Map of Catalonia, scenarios have been constructed for the development and adaptation of services for the 2015 horizon. The territorial scale is that of the 37 areas into which Catalonia has been divided in order to promote a new form of decentralised, combined decision- making, through the Territorial Health Governments. The new territorial health organisation is the substrate which must enable the relationship between professionals and services that share the same reference population to be coordinated. This article deals with the methodology for constructing the scenarios, and a summary is given of the principal action proposals which arise from the map in the aforementioned 37 territories. Detailed content of the territorial scenarios is also given, based on two practical cases.
The overarching aim of this study is to develop a GIS-based planning approach that contributes to equitable and efficient provision of urban health services in cities in sub-Saharan Africa. Its prime concern is with (i) the identification of theoretical and methodological constructs that can be used to analyse and improve the spatial performance of public health service delivery systems, and (ii) the development of a corresponding spatial-analytic and GIS-based planning approach using Dar es ...
This paper, by way of a narrative on the author's participation, explains the limits to a planned cultural change program in a large rural health service. Cultural change was identified by the CEO as crucial to the success of a major restructuring of the service, and the attitudes and beliefs of the 'old guard' were considered to be constraining progress. Advocates of cultural integration contend that shared core values across an organisation can overcome such obstacles. This is a matter of faith. An application of Habermasian theory suggests that organisational leaders are drawing on traditional/religious beliefs and practices to bolster their visions and missions at a time of motivational crisis. Though a need for cultural change in some sectors of the health services is acknowledged, the particular challenges in attempting to manipulate the traditionally embedded culture and sub-cultures of the health services is highlighted. An analysis of some of the ideas and beliefs surrounding authority, deference and discipline is undertaken. It is argued that the ritualistic reinforcement of these beliefs and the reproduction of sub-cultures along material and ideal interests militate against the implementation of objectives delineated by the CEO. While cultural analysis has revealed the irrational face of organisations and can bring to conscious awareness the taken-for-granted beliefs which inform behaviour, the cultural integrationists have a further agenda. They aim to manipulate organisational culture to subtly control employees' beliefs and hence behaviour. Cultural control is a covert form of top down authority that can be just as directive and centralizing as bureaucratic control. The author also maintains that cultural change programs alone cannot fix a problem that arose in the macro-economic sphere: a chronic lack of resources ever since the state responded to the economic crisis by cutting funds to health and welfare services.
de Britto, Felipe A; Martins, Tatiana B; Landsberg, Gustavo A P
To assess impact of a mobile health solution in the nursing care plan compliance of a home care service. A retrospective cohort study was performed with 3,036 patients. Compliance rates before and after the implementation were compared. After the implementation of a mobile health aplication, compliance with the nursing care plan increased from 53% to 94%. The system reduced IT spending, increased the nursing team efficiency and prevented planned hiring. The use of a mobile health solution with geolocating feature by a nursing home care team increased compliance to the care plan.
Full Text Available In the past, health planning in Iran has been carried out in the context of short-range economic plans. Although this mechanism has helped a great deal in the achievement of certain health plans however, the said scheme has been short in meeting the health objectives on a comprehensive basis. Most often, the heath programs have lost their values to the priority and cost effectiveness of economic plans. A brief review of heath planning in the past shows that the second development plan has been devoted to the establishment of new hospitals on a scattered pattern. The development of a coordinated hospital and health center system has been accepted and partly implemented during the third plan period. In the fourth plan the whole direction has changed towards the development of private hospitals on profit making basis, and now the fifth plan calls for the regionalized hospital system. Thus, one can say that the past twenty years have been spent to the experimentation of different schemes without a real long-range goal. In the past decade the World Health Organization has ventured in the development of health planning principles, but most of the efforts have been devoted to the short-range planning. The long-range health planning is not only a new look to the principles of planning, but a thorough examination of the time factor in health planning.
Jivanjee, Pauline; Kruzich, Jean M.; Friesen, Barbara J.; Robinson, Adjoa
Family participation in educational planning for children with disabilities is believed to result in plans that are more responsive to the child's needs and that lead to better social, emotional, and educational outcomes. Participation in educational planning is also a fundamental right of parents and a cornerstone of special education…
Greenberg, Greg A; Rosenheck, Robert A
In federal fiscal year (FY) 2005 the Department of Veterans Affairs (VA) implemented the comprehensive Mental Health Strategic Plan (MHSP). This study used performance measures from six broad domains to examine changes in the overall delivery of mental health services in the VA since the implementation of the MHSP. Performance measures from fiscal year 2004, the year before implementation of the MHSP, were compared with measures from fiscal years 2005, 2006, and 2007, the first 3 years of MHSP implementation. We combined heterogeneous performance measures within domains through the use of standardized scores or "z-scores." An overall improvement of 0.32 standardized units was observed from FY 2004 to FY 2007, representing moderate to large changes by conventional standards. The domains with the greatest improvement (>1.0 standard deviation units) from FY 2004 to FY 2007 were population coverage/access, outpatient care quality, economic performance (primarily efficiency), and global functioning. There was a 0.3 standard deviation decline in inpatient satisfaction and a slight increase in reliance on inpatient care. Overall improvement in VA mental health care was thus substantial and continuing.
The aim of the present paper was to review the opportunities currently available to health service planners to advance sustainable development in their future-facing roles within health service organisation. Critical challenges and enablers to facilitate health services planners in adopting a pro-environmental lens are discussed.What is known about the topic? Despite its harmful effect on the environment, health has been slower than other industries to embrace the sustainable development agenda. The attitudes and knowledge base of health service planners with regard to environmental sustainability has not been widely studied. For health service planners, embracing pro-environmental considerations in sustainable model of care development is a powerful opportunity to review care paradigms and prepare for the implementation of meaningful, improved health and system efficiency.What does this paper add? This paper advances the case for health service planners to embrace a pro-environmental stance and guides health service leaders in the preparation and implementation of sustainable and improved health and system efficiency.What are the implications for practitioners? Health service planers are in an ideal position to champion the sustainable development agenda as they explore what care is delivered, how care is delivered and where care is delivered. External policy, health service leadership and carbon literacy are advanced as critical contextual factors to facilitate the key role that health service planners can play in building sustainable healthcare organisations.
Lee, Yong Yi; Meurk, Carla S; Harris, Meredith G; Diminic, Sandra; Scheurer, Roman W; Whiteford, Harvey A
... of services that are meaningful for policy makers. The 'service platform' is an emerging concept that could be used to this end, however no explicit definition currently exists in the literature...
Amo-Adjei, Joshua; Anamaale Tuoyire, Derek
We analysed the extent of planned, mistimed and unwanted pregnancies and how they predict optimal use of prenatal (timing and number of antenatal) care services in 30 African countries. We pooled data from Demographic and Health Surveys conducted in 30 African countries between 2006 and 2015. We described the extent of mistimed and unwanted pregnancies and further used mixed effects logistic and Poisson regression estimation techniques to examine the impacts of planned, mistimed and unwanted pregnancies on the use of prenatal health services. In total, 73.65% of pregnancies in all countries were planned. Mistimed pregnancy ranged from 7.43% in Burkina Faso to 41.33% in Namibia. Unwanted pregnancies were most common in Swaziland (39.54%) and least common in Niger (0.74%). Timely (first trimester) initiation of ANC was 37% overall in all countries; the multicountry average number of ANC visits was optimal [4.1; 95% CI: 4.1-4.2] but with notable disparities between countries. Overall, mistimed and unwanted pregnancies were strongly associated with late ANC attendance and fewer visits women made in the pooled analysis. Unintended pregnancies are critical risks to achieving improved maternal health in respect of early and optimal ANC coverage for women in Africa. Programmes targeted at advancing coverage of ANC in Africa need to deploy contextually appropriate mechanisms to prevent unintended pregnancies. © 2016 John Wiley & Sons Ltd.
Inclusivity and dementia: health services planning with individuals with dementia: effective inclusion requires action at multiple levels by individuals with dementia, care partners, service providers and funding organizations.
Whitfield, Kyle; Wismer, Susan
Historically, Alzheimer societies have identified the care partners of persons with dementia as their central clients. This focus is broadening to include the person with the disease, as well. This paper presents the results of a Canadian research study addressing organizational considerations related to effective inclusion of persons with dementia in planning and decision-making about health services and programs. Our findings suggest that effective inclusion requires action at multiple levels by individuals with dementia, care partners and friends; service organizations and providers; and funding organizations. Additional research is needed to explore the applicability of these findings to other organizations in different localities and to examine emergent themes further. Of these, one that has received little attention to date concerns the potential risks associated with effective inclusion.
Alexander, H. M.
In computer program NOROCA populations statistics from National Center for Health Statistics used with computational procedure to estimate health service utilization rates, physician demands (by specialty) and hospital bed demands (by type of service). Computational procedure applicable to health service area of any size and even used to estimate statewide demands for health services.
Rhee, YongJoo; Taitel, Michael S; Walker, David R; Lau, Denys T
This study examines the risk factors of narcotic drug use, medical and pharmacy claim costs, and health services use among lower back pain (LBP) patients who use narcotic medications. This retrospective study used administrative claims data between September 2002 and March 2004 from 3 employer health plans that collectively contained records of 165,569 employees 18 to 64 years of age. Multivariate regression analyses were performed to examine risk factors and health care services use consequences of narcotic drug use in patients with LBP. The study sample included 13,760 patients with LBP due to mechanical causes. Nearly 60% were female and the average age was 47 years. Almost half of the patients with LBP (45%) used narcotic drugs. Narcotic-using patients with LBP had significantly higher rates of comorbid conditions than patients with LBP not using narcotic drugs; hypertension (23% vs 13%), arthritis (14% vs 4%), depression (10% vs 5%), anxiety (6% vs 3%), and cancer (2% vs 1%) (Pchiropractic services for LBP were less likely to take narcotic drugs within 7 days after services compared to those without chiropractic services (P<0.001). Furthermore, controlling for health conditions, patients with LBP who took narcotic medications were significantly more likely than patients not taking narcotics to have an emergency room visit within 30 days after the initial narcotic drug prescription dates (P<0.001). Narcotic-using patients with LBP accounted for 62% of health care costs among all patients with LBP. The average monthly health care cost for a narcotic-using LBP patient was $1222, compared to $430 for a LBP patient not using narcotic drugs (P<0.001). The subjects with LBP who used narcotic medications were more likely to have additional coexisting health conditions and used more health care services than nonusing patients with LBP (P<0.001). Unadjusted health care services costs, including pharmacy claims costs, were significantly higher in patients with LBP using
6010.8-R, plus all preventive services recommended by the U.S. Preventive Services Task Force.12 It does not include a dental benefit. The USFHP benefit...20 The USFHP does not include a dental benefit. 10 I I I I I I I I I I I I I I I I I I I active-duty members, were able to use...Military Medical Care Beneficiaries, more commonly referred to as the "Section 733 Survey.൪ It 33 Clement, Dolores G., et al. "Access and Outcomes
Full Text Available Adolescents represent a large proportion of the population. As they mature and become sexually active, they face more serious health risks. Most face these risks with too little factual information, too little guidance about sexual responsibility and multiple barriers to accessing health care. A typical descriptive and explanatory design was used to determine what the characteristics of an accessible adolescent health service should be. Important results and conclusions that were reached indicate that the adolescent want a medical doctor and a registered nurse to be part of the health team treating them and they want to be served in the language of their choice. Family planning, treatment of sexually transmitted diseases and psychiatric services for the prevention of suicide are services that should be included in an adolescent accessible health service. The provision of health education concerning sexual transmitted diseases and AIDS is a necessity. The service should be available thought out the week (included Saturdays and within easy reach. It is recommended that minor changes in existing services be made, that will contribute towards making a health delivery service an adolescent accessible service. An adolescent accessible health service can in turn make a real contribution to the community’s efforts to improve the health of its adolescents and can prove to be a rewarding professional experience to the health worker.
Scott, Valerie K; Gottschalk, Lindsey B; Wright, Kelsey Q; Twose, Claire; Bohren, Meghan A; Schmitt, Megan E; Ortayli, Nuriye
This systematic review evaluates the strength of the evidence that community health workers' (CHW) provision of family planning (FP) services in low- and middle-income countries is effective. In a search of eight databases, articles were screened by study design and outcome measure and ranked by strength of evidence. Only randomized trials, longitudinal studies with a comparison group, and pre-test/post-test studies met inclusion criteria. A total of 56 studies were included. Of those studies with relevant data, approximately 93 percent indicated that CHW FP programs effectively increased the use of modern contraception, while 83 percent reported an improvement in knowledge and attitudes concerning contraceptives. Based on these findings, strong evidence exists for promoting CHW programs to improve access to FP services. We recommend a set of best practice guidelines that researchers and program managers can use to report on CHW FP programs to facilitate the translation of research to practice across a wide range of settings. © 2015 The Population Council, Inc.
Evaluation indicators, used for assessing work in a specific time period, play a guiding role in every area and are vital for making work plans. GDP, an important economic indicator, is often used to measure the strength of a country. It is also an indicator used in China to evaluate the performance of local governments This practice has proven to be effective in stimulating economic growth within a certain time period.However, the consequences of focusing only on economic indicators are beginning to loom large as time passes. It comes at the cost of social and public interest and sustainability of economic development.
To inaugurate the fifth year of its publication, The American Heart Hospital Journal (AHHJ) focused its Winter 2007 issue on health care systems from around the world, with 8 articles contributed by national leaders in their respective countries. Due to the interest and wide range of expertise in the international cardiac community, we will continue to publish Special Reports throughout 2007 on this topic. We invite members of the international community to share with readers of the AHHJ, their insights on the strengths and weaknesses of their respective health care and cardiac care systems, as well as their ideas and aspirations for future change.
The overarching aim of this study is to develop a GIS-based planning approach that contributes to equitable and efficient provision of urban health services in cities in sub-Saharan Africa. Its prime concern is with (i) the identification of theoretical and methodological constructs that can be used
The overarching aim of this study is to develop a GIS-based planning approach that contributes to equitable and efficient provision of urban health services in cities in sub-Saharan Africa. Its prime concern is with (i) the identification of theoretical and methodological constructs that can be used
Schuurman, Nadine; Randall, Ellen; Berube, Myriam
There is mounting pressure on healthcare planners to manage and contain costs. In rural regions, there is a particular need to rationalize health service allocation to ensure the best possible coverage for a dispersed population. Rural health administrators need to be able to quantify the population affected by their allocation decisions and, therefore, need the capacity to incorporate spatial analyses into their decision-making process. Spatial decision support systems (SDSS) can provide this capability. In this article, we combine geographical information systems (GIS) with a web-based graphical user interface (webGUI) in a SDSS tool that enables rural decision-makers charged with service allocation, to estimate population catchments around specific health services in rural and remote areas. Using this tool, health-care planners can model multiple scenarios to determine the optimal location for health services, as well as the number of people served in each instance.
Green, Geoff; Acres, John; Price, Charles; Tsouros, Agis
The objective of this evaluation was to review the evolution and process of city health development planning (CHDP) in municipalities participating in the Healthy Cities Network organized by the European Region of the World Health Organization. The concept of CHDP combines elements from three theoretical domains: (a) health development, (b) city governance and (c) urban planning. The setting was the 56 cities which participated in Phase III (1998-2002) of the Network. Evidence was gathered from documents either held in WHO archives or made available from Network cities and from interviews with city representatives. CHDPs were the centrepiece of Phase III, evolving from city health plans developed in Phase II. They are strategic documents giving direction to municipalities and partner agencies. Analysis revealed three types of CHDP, reflecting the realpolitik of each city. For many cities, the process of CHDP was as important as the plan itself.
Goodman, Robert M.; Powell, Corey C.; Park, Paul
Study Design. An observational study. Objective. The aim of this study was to evaluate the impact of a health plan's prior authorization (PA) programs for low back pain (LBP) in a non-Medicare population by assessing changes in pre-surgical nonoperative care; lumbar fusion trends; and overall back surgery rates compared with another health plan with a similar program and national benchmarks. The PA programs require mandatory physiatrist consultation before surgical evaluation, with subsequent additional LBP surgery PA. Summary of Background Data. LBP is prevalent and concern exists that spinal fusion is overutilized for LBP. Methods. Annual rates of lumbar fusion trended over 6 years, and analysis of changes in standardized costs for LBP-related services among a 501-member subset who underwent lumbar fusion before and after program implementations, during the period January 1, 2008, through December 31, 2013, among commercial members aged 18 and 65 years enrolled in a health maintenance organization with commercial membership averaging >500,000 annually. Results. After initiation of the physiatrist PA in December 2010, lumbar fusions decreased from 76.27/100,000 in 2010 to 62.63/100,000 in 2011 with subsequent increases to 64.24/100,000 and 73.84/100,000 in years 2012 and 2013. For members who had lumbar fusion, per-member, pre-surgical costs increased by $2,233 with the physiatrist PA and an additional $1,370 with implementation of the LBP surgery PA (March 2013). Spinal injections and inpatient admissions were the greatest contributors to the overall increase in costs. The physiatrist and LBP surgery PA programs were also associated with lengthening of LBP episodes ending in surgery by 309 and 198 days. Conclusion. Mandatory referral to a physiatrist before surgical evaluation did not result in persistent reduction in lumbar fusions. Instead, these programs were associated with the unintended consequence of increased costs from more nonoperative care for only a
... HUMAN SERVICES Health Resources and Services Administration Agency Information Collection Activities... and Services Administration (HRSA) publishes periodic summaries of proposed projects being developed...: The Health Resources and Services Administration (HRSA) plans to conduct a survey of the...
Arcos González, Pedro; Castro Delgado, Rafael; Cuartas Alvarez, Tatiana; Pérez-Berrocal Alonso, Jorge
Today the terrorism is a problem of global distribution and increasing interest for the international public health. The terrorism related violence affects the public health and the health care services in an important way and in different scopes, among them, increase mortality, morbidity and disability, generates a context of fear and anxiety that makes the psychopathological diseases very frequent, seriously alters the operation of the health care services and produces important social, political and economic damages. These effects are, in addition, especially intense when the phenomenon takes place on a chronic way in a community. The objective of this paper is to examine the relation between terrorism and public health, focusing on its effects on public health and the health care services, as well as to examine the possible frames to face the terrorism as a public health concern, with special reference to the situation in Spain. To face this problem, both the public health systems and the health care services, would have to especially adapt their approaches and operational methods in six high-priority areas related to: (1) the coordination between the different health and non health emergency response agencies; (2) the reinforcement of the epidemiological surveillance systems; (3) the improvement of the capacities of the public health laboratories and response emergency care systems to specific types of terrorism as the chemical or biological terrorism; (3) the mental health services; (4) the planning and coordination of the emergency response of the health services; (5) the relations with the population and mass media and, finally; (6) a greater transparency in the diffusion of the information and a greater degree of analysis of the carried out health actions in the scope of the emergency response.
In light of the increasing globalization of the health sector, this article examines ways in which health services can be traded, using the mode-wise characterization of trade defined in the General Agreement on Trade in Services. The trade modes include cross- border delivery of health services via physical and electronic means, and cross-border movement of consumers, professionals, and capital. An examination of the positive and negative implications of trade in health services for equity, efficiency, quality, and access to health care indicates that health services trade has brought mixed benefits and that there is a clear role for policy measures to mitigate the adverse consequences and facilitate the gains. Some policy measures and priority areas for action are outlined, including steps to address the "brain drain"; increasing investment in the health sector and prioritizing this investment better; and promoting linkages between private and public health care services to ensure equity. Data collection, measures, and studies on health services trade all need to be improved, to assess better the magnitude and potential implications of this trade. In this context, the potential costs and benefits of trade in health services are shaped by the underlying structural conditions and existing regulatory, policy, and infrastructure in the health sector. Thus, appropriate policies and safeguard measures are required to take advantage of globalization in health services.
According to the China national programme of economic and social development, by 2000 the standard of living of Chinese people will have been fairly welloff. In order to accomplish the goal, the government has comprised the population development in the national social economic development programme. Family planning (FP) work will contribute to the general goal of social economy and development. Reform and open policy and establishment of socialist market economy sys
U.S. Department of Health & Human Services — This page contains several useful trend and competition indicators. Certain files will be updated monthly while others will be updated quarterly. The files are the...
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Full Text Available Abstract Background Public and private family planning providers face different incentive structures, which may affect overall quality and ultimately the acceptability of family planning for their intended clients. This analysis seeks to quantify differences in the quality of family planning (FP services at public and private providers in three representative sub-Saharan African countries (Tanzania, Kenya and Ghana, to assess how these quality differentials impact upon FP clients' satisfaction, and to suggest how quality improvements can improve contraceptive continuation rates. Methods Indices of technical, structural and process measures of quality are constructed from Service Provision Assessments (SPAs conducted in Tanzania (2006, Kenya (2004 and Ghana (2002 using direct observation of facility attributes and client-provider interactions. Marginal effects from multivariate regressions controlling for client characteristics and the multi-stage cluster sample design assess the relative importance of different measures of structural and process quality at public and private facilities on client satisfaction. Results Private health facilities appear to be of higher (interpersonal process quality than public facilities but not necessarily higher technical quality in the three countries, though these differentials are considerably larger at lower level facilities (clinics, health centers, dispensaries than at hospitals. Family planning client satisfaction, however, appears considerably higher at private facilities - both hospitals and clinics - most likely attributable to both process and structural factors such as shorter waiting times and fewer stockouts of methods and supplies. Conclusions Because the public sector represents the major source of family planning services in developing countries, governments and Ministries of Health should continue to implement and to encourage incentives, perhaps performance-based, to improve quality at public
Does the design and implementation of proven innovations for delivering basic primary health care services in rural communities fit the urban setting: the case of Ghana’s Community-based Health Planning and Services (CHPS)
Background Rapid urban population growth is of global concern as it is accompanied with several new health challenges. The urban poor who reside in informal settlements are more vulnerable to these health challenges. Lack of formal government public health facilities for the provision of health care is also a common phenomenon among communities inhabited by the urban poor. To help ameliorate this situation, an innovative urban primary health system was introduced in urban Ghana, based on the milestones model developed with the rural Community-Based Health Planning and Services (CHPS) system. This paper provides an overview of innovative experiences adapted while addressing these urban health issues, including the process of deriving constructive lessons needed to inform discourse on the design and implementation of the sustainable Community-Based Health Planning and Services (CHPS) model as a response to urban health challenges in Southern Ghana. Methods This research was conducted during the six-month pilot of the urban CHPS programme in two selected areas acting as the intervention and control arms of the design. Daily routine data were collected based on milestones initially delineated for the rural CHPS model in the control communities whilst in the intervention communities, some modifications were made to the rural milestones. Results The findings from the implementation activities revealed that many of the best practices derived from the rural CHPS experiment could not be transplanted to poor urban settlements due to the unique organizational structures and epidemiological characteristics found in the urban context. For example, constructing Community Health Compounds and residential facilities within zones, a central component to the rural CHPS strategy, proved inappropriate for the urban sector. Night and weekend home visit schedules were initiated to better accommodate urban residents and increase coverage. The breadth of the disease burden of the urban
Does the design and implementation of proven innovations for delivering basic primary health care services in rural communities fit the urban setting: the case of Ghana's Community-based Health Planning and Services (CHPS).
Adongo, Philip Baba; Phillips, James F; Aikins, Moses; Arhin, Doris Afua; Schmitt, Margaret; Nwameme, Adanna U; Tabong, Philip Teg-Nefaah; Binka, Fred N
Rapid urban population growth is of global concern as it is accompanied with several new health challenges. The urban poor who reside in informal settlements are more vulnerable to these health challenges. Lack of formal government public health facilities for the provision of health care is also a common phenomenon among communities inhabited by the urban poor. To help ameliorate this situation, an innovative urban primary health system was introduced in urban Ghana, based on the milestones model developed with the rural Community-Based Health Planning and Services (CHPS) system. This paper provides an overview of innovative experiences adapted while addressing these urban health issues, including the process of deriving constructive lessons needed to inform discourse on the design and implementation of the sustainable Community-Based Health Planning and Services (CHPS) model as a response to urban health challenges in Southern Ghana. This research was conducted during the six-month pilot of the urban CHPS programme in two selected areas acting as the intervention and control arms of the design. Daily routine data were collected based on milestones initially delineated for the rural CHPS model in the control communities whilst in the intervention communities, some modifications were made to the rural milestones. The findings from the implementation activities revealed that many of the best practices derived from the rural CHPS experiment could not be transplanted to poor urban settlements due to the unique organizational structures and epidemiological characteristics found in the urban context. For example, constructing Community Health Compounds and residential facilities within zones, a central component to the rural CHPS strategy, proved inappropriate for the urban sector. Night and weekend home visit schedules were initiated to better accommodate urban residents and increase coverage. The breadth of the disease burden of the urban residents also requires a
Robert E. Moffit PhD
Full Text Available We discuss and evaluate the Multi-State Plan (MSP Program, a provision of the Affordable Care Act that has not been the subject of much debate as yet. The MSP Program provides the Office of Personnel Management with new authority to negotiate and implement multistate insurance plans on all health insurance exchanges within the United States. We raise the concern that the MSP Program may lead to further consolidation of the health insurance industry despite the program’s stated goal of increasing competition by means of health insurance exchanges. The MSP Program arguably gives a competitive advantage to large insurers, which already dominate health insurance markets. We also contend that the MSP Program’s failure to produce increased competition may motivate a new effort for a public health insurance option.
Ghanshyam K Bhatta
Full Text Available Background: Family Planning (FP is a key developmental focus for the government of Nepal. Use of modern contraceptives has stagnated at 43.2% since 2011. Unmet need for family planning (FP in Nepal remains high at 27%. Despite relatively high unmet need, a factor contributing to this levelling of contraceptive use is the limited range of methods available to most clients at most sites. To address the FP need among married women of reproductive age (WRA, we tested integration of FP into agricultural programs. Aim: To assess the effectiveness of a FP program integrated into an agriculture (e.g., non-health sector program. Methods: A descriptive cross-sectional (post interventional study was conducted November 2015 to February 2016 among 525 WRA participating in an agriculture program. Results: The contraceptives commonly used by women in the study location were Depo Provera and Minilap. After Technical Integration Coverage and Access (TICA interventions, almost all of the respondents (99.6% had heard about FP of which 67.8% correctly understood FP as a method to prevent unwanted pregnancy. About 50% of the respondents were found currently using FP. The percentage of WRA aware of long-acting and permanent FP methods increased from 49.0% to 62.0% and 39.0% to 52.0% respectively. Decisions on using a FP method were predominantly made by the husband (68.0%. However, 68.4% women reported that they were accompanied by their husband. The proportion of men willing to use FP increased from 5.2% to 15.5% after TICA activities implementation. The main reason identified for not currently using FP devices was that the husband and wife were not living together (88.8%. Most of the women (98.0% reported that FP utilization improved their quality of life. Conclusion: TICA activities were very successful in both increasing FP knowledge level as well as utilizing FP services among the targeted beneficiaries. The use of FP increased among agriculture program
Fraser, C; Grundy, A; Meade, O; Callaghan, P; Lovell, K
alongside ongoing support and supervision. Mental health nurses (and other health professionals) will be better able to involve service users and carers in care planning. Service users and carers may feel more involved in care planning in future.
Petersen, Inge; Bhana, Arvin; Campbell-Hall, Victoria; Mjadu, Sithembile; Lund, Crick; Kleintjies, Sharon; Hosegood, Victoria; Flisher, Alan J
The shift in emphasis to universal primary health care in post-apartheid South Africa has been accompanied by a process of decentralization of mental health services to district level, as set out in the new Mental Health Care Act, no. 17, of 2002 and the 1997 White Paper on the Transformation of the Health System. This study sought to assess progress in South Africa with respect to deinstitutionalization and the integration of mental health into primary health care, with a view to understanding the resource implications of these processes at district level. A situational analysis in one district site, typical of rural areas in South Africa, was conducted, based on qualitative interviews with key stakeholders and the World Health Organization's Assessment Instrument for Mental Health Systems (WHO-AIMS). The findings suggest that the decentralization process remains largely limited to emergency management of psychiatric patients and ongoing psychopharmacological care of patients with stabilized chronic conditions. We suggest that, in a similar vein to other low- to middle-income countries, deinstitutionalization and comprehensive integrated mental health care in South Africa is hampered by a lack of resources for mental health care within the primary health care resource package, as well as the inefficient use of existing mental health resources.
Brunie, Aurélie; Wamala-Mucheri, Patricia; Akol, Angela; Mercer, Sarah; Chen, Mario
Improving HIV testing and counselling (HTC) requires a range of strategies. This article reports on HTC service delivery by Village Health Teams (VHTs) in Uganda in the context of a model integrating this new component into pre-existing family planning services. Eight health centres from matched pairs were randomly allocated to intervention or control. After being trained, 36 VHTs reporting to selected facilities in the intervention group started offering HTC along with family planning, while VHTs in the control group provided family planning only. Proficiency testing was conducted as external quality assurance. A survey of all 36 VHTs and 137 family planning clients in the intervention group and 119 clients in the control group and a review of record data were conducted after 10 months. Survey responses by VHTs and their clients in the intervention group demonstrate knowledge of counselling messages and safe testing. External quality assessment results provide additional evidence of competency. Eighty per cent of the family planning clients surveyed in the intervention group received an HIV test during the intervention; 27% of those were first-time testers. More clients had ever tested for HIV in the intervention group compared with the control; clients also retested more often. Findings indicate that this model is feasible and acceptable for expanding quality HTC into communities. This study was registered with ClinicalTrials.gov, number [NCT02244398].
Cole, L; Finger, W R
Few family planning programs provide sexually transmitted disease (STD) services. Yet, more and more policymakers and program managers are thinking of ways that family planning programs can address reproductive health needs, including STDs. Family planning programs that have already added STD services now operate in Botswana, Kenya, Malawi, India, Sri Lanka, Brazil, Colombia, El Salvador, and Jamaica. Most of them concentrate on STD/AIDS preventive services: providing information, counseling, and promoting condom use. Some programs also provide STD management services. A family planning clinic in Nairobi, Kenya, gradually integrated STD services into its program. It first provided clients with information about STDs, then nurses were trained to diagnose and treat STDs, and last the clinic began receiving STD drugs. This clinic targets low-income workers and groups at high risk for HIV infection. It has 60 outreach volunteers working in bars, brothels, and small shops. During September 1991-March 1994, 57% of clients used condoms. The nurses use a syndromic approach to decide on what treatment to use for STD patients. Since some women do not have obvious STD symptoms, laboratories and microscopes are used to make an accurate diagnosis. A considerable outlay of funds is needed for extensive training in STD diagnosis and treatment, but ending the cycle of infection saves money. Concerns about contraceptive effectiveness of barrier methods keep family planning programs from promoting condom use. Another obstacle to integrating STD services into family planning programs is that most programs focus on women. Clinics should encourage couples to be together for family planning and STD counseling. They can also direct educational materials to men. Other challenges include the difficulty of diagnosing STDs in women, expensive and often unavailable STD drugs, reinfection by partners who do not receive treatment, and lack of power to insist on condom use.
A cluster randomised controlled trial and process evaluation of a training programme for mental health professionals to enhance user involvement in care planning in service users with severe mental health issues (EQUIP): study protocol for a randomised controlled trial.
Bower, Peter; Roberts, Chris; O'Leary, Neil; Callaghan, Patrick; Bee, Penny; Fraser, Claire; Gibbons, Chris; Olleveant, Nicola; Rogers, Anne; Davies, Linda; Drake, Richard; Sanders, Caroline; Meade, Oonagh; Grundy, Andrew; Walker, Lauren; Cree, Lindsey; Berzins, Kathryn; Brooks, Helen; Beatty, Susan; Cahoon, Patrick; Rolfe, Anita; Lovell, Karina
Involving service users in planning their care is at the centre of policy initiatives to improve mental health care quality in England. Whilst users value care planning and want to be more involved in their own care, there is substantial empirical evidence that the majority of users are not fully involved in the care planning process. Our aim is to evaluate the effectiveness and cost-effectiveness of training for mental health professionals in improving user involvement with the care planning processes. This is a cluster randomised controlled trial of community mental health teams in NHS Trusts in England allocated either to a training intervention to improve user and carer involvement in care planning or control (no training and care planning as usual). We will evaluate the effectiveness of the training intervention using a mixed design, including a 'cluster cohort' sample, a 'cluster cross-sectional' sample and process evaluation. Service users will be recruited from the caseloads of care co-ordinators. The primary outcome will be change in self-reported involvement in care planning as measured by the validated Health Care Climate Questionnaire. Secondary outcomes include involvement in care planning, satisfaction with services, medication side-effects, recovery and hope, mental health symptoms, alliance/engagement, well-being and quality of life. Cost- effectiveness will also be measured. A process evaluation informed by implementation theory will be undertaken to assess the extent to which the training was implemented and to gauge sustainability beyond the time-frame of the trial. It is hoped that the trial will generate data to inform mental health care policy and practice on care planning. ISRCTN16488358 (14 May 2014).
Integrating systematic screening for gender-based violence into sexual and reproductive health services: results of a baseline study by the International Planned Parenthood Federation, Western Hemisphere Region.
Guedes, A; Bott, S; Cuca, Y
Three Latin American affiliates of the International Planned Parenthood Federation, Western Hemisphere Region, Inc. (IPPF/WHR) have begun to integrate gender-based violence screening and services into sexual and reproductive health programs. This paper presents results of a baseline study conducted in the affiliates. Although most staff support integration and many had already begun to address violence in their work, additional sensitization and training, as well as institution-wide changes are needed to provide services effectively and to address needs of women experiencing violence.
Jones, Lorelei; Exworthy, Mark
This paper reports from an ethnographic study of hospital planning in England undertaken between 2006 and 2009. We explored how a policy to centralise hospital services was espoused in national policy documents, how this shifted over time and how it was translated in practice. We found that policy texts defined hospital planning as a clinical issue and framed decisions to close hospitals or hospital departments as based on the evidence and necessary to ensure safety. We interpreted this framing as a rhetorical strategy for implementing organisational change in the context of community resistance to service closure and a concomitant policy emphasising the importance of public and patient involvement in planning. Although the persuasive power of the framing was limited, a more insidious form of power was identified in the way the framing disguised the political nature of the issue by defining it as a clinical problem. We conclude by discussing how the clinical rationale constrains public participation in decisions about the delivery and organisation of healthcare and restricts the extent to which alternative courses of action can be considered. Copyright © 2014 Elsevier Ltd. All rights reserved.
... 42 Public Health 4 2010-10-01 2010-10-01 false State plan requirement: Procedures to address substitution under group health plans. 457.805 Section 457.805 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) STATE CHILDREN'S HEALTH INSURANCE PROGRAMS...
Achyut, Pranita; Mishra, Anurag; Montana, Livia; Sengupta, Ranajit; Calhoun, Lisa M; Nanda, Priya
Maternal health (MH) services provide an invaluable opportunity to inform and educate women about family planning (FP). It is expected that this would enable women to choose an appropriate method and initiate contraception early in the postpartum period. In this study we examined interactions with health providers for MH services, and the effect of FP information provision during these interactions on the postpartum use of modern contraceptive methods. This study used midline data collected from 990 women who had delivered a live birth between January 2010 and the date of the midline survey in 2012. These women were asked a series of questions about their last delivery, including interactions with health providers during pregnancy, delivery and the postpartum period, if they received FP information during these interactions, and their contraceptive use during the postpartum period. The study found that FP information provision as part of antenatal care in the third trimester, delivery and the postpartum period have a positive association with postpartum modern contraceptive use in urban Uttar Pradesh. However, health providers often miss these opportunities. Despite a high proportion of women coming into contact with health providers when utilising MH services, only a small proportion received FP information during these interactions. Integration of FP with MH services can increase postpartum modern contraceptive use. With the launch of the National Urban Health Mission, there now exists appropriate policy and programmatic environments for integration of FP and MH services in urban settings in India. However, this will require a concentrated effort both to enhance the capacity of health providers and encourage supportive supervision. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/
... 42 Public Health 1 2010-10-01 2010-10-01 false Accord with health planning. 56.105 Section 56.105... HEALTH SERVICES General Provisions § 56.105 Accord with health planning. A grant may be made under this... appropriate health planning agencies have been met. ...
... 42 Public Health 1 2010-10-01 2010-10-01 false Accord with health planning. 51c.105 Section 51c... COMMUNITY HEALTH SERVICES General Provisions § 51c.105 Accord with health planning. A grant may be made... approval by the appropriate health planning agencies have been met. ...
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Kazmerski, Traci; McCauley, Heather L; Jones, Kelley; Borrero, Sonya; Silverman, Jay G; Decker, Michele R; Tancredi, Daniel; Miller, Elizabeth
To examine the associations of recent intimate partner violence (IPV) and reproductive coercion (RC) with frequency of use of reproductive and sexual health services, a cross-sectional survey was administered to 16-29 year old women seeking care in five family planning clinics (n = 1,262). We evaluated associations of recent experiences of IPV, RC, or both IPV and RC with recent care seeking for pregnancy testing, emergency contraception, and sexually transmitted infection testing using multinomial logistic regression. Sixteen percent of respondents reported IPV and 13.5 % reported RC in the past 3 months. Four percent of all respondents reported both IPV and RC. Recent RC without IPV was associated with increased odds of seeking one (AOR = 2.0, 95 % CI 1.3-2.9) or multiple pregnancy tests (AOR = 2.3, 95 % CI 1.2-4.5), multiple STI tests (AOR = 2.5, 95 % CI 1.5-4.1), or using emergency contraception once (AOR = 2.6, 95 % CI 1.2-5.8) or multiple times (AOR = 2.2, 95 % CI 1.7-2.7). Recent IPV without RC was associated with increased odds of seeking one (AOR = 1.4, 95 % CI 1.1-1.7) or multiple pregnancy tests (AOR = 2.2, 95 % CI 1.4-3.2) and using emergency contraception once (AOR = 1.6, 95 % CI 1.3-2.0). The combined effect of recent IPV and RC increased the odds of seeking multiple pregnancy tests (AOR = 3.6, 95 % CI 3.3-3.8), using emergency contraception multiple times (AOR = 2.4, 95 % CI 1.5-4.1) and seeking STI testing once (AOR = 2.5, 95 % CI 1.6-3.9) or multiple times (AOR = 2.9, 95 % CI 1.02-8.5). Frequent requests for pregnancy and STI testing and emergency contraception among young females seeking care may be an indicator of greater risk for recent RC, alone and in combination with IPV.
Silvestro, Rhian; Silvestro, Claudio
Despite the criticality of nurse rostering practices, there is a surprising lack of attention paid to this managerial activity both in practice and in the health-service management literature. This paper reports the results of an inductive, empirical study of rostering practices in the UK National Health Service with a view to developing a shared understanding of roster planning processes and of what constitutes rostering effectiveness. A survey of rostering practices in 50 wards, followed by five in-depth, longitudinal case studies, revealed the complexity of rostering activities, and identified the main design parameters, which were used to specify rostering systems and to prepare periodic rosters. Rostering activities were perceived to directly impact upon service delivery, resource utilization and nurse retention. A number of poor rostering practices were identified, which could lead to dysfunctional behaviour. This analysis points to a clear managerial imperative to improve local competencies in roster planning and control, recognizing their strategic significance in contributing to hospital effectiveness. A 'Strategic Roster Planning and Control (SRPC)' model is proposed, which may provide a framework for evaluating rostering effectiveness, and a platform for the sharing of best practice, in order to stimulate organizational learning and achieve nationwide improvements in hospital performance.
U.S. Department of Health & Human Services — This study assesses the financial performance of health plans that enroll Medicaid members across the key plan traits, specifically Medicaid dominant, publicly...
U.S. Department of Health & Human Services — This study assesses the financial performance of health plans that enroll Medicaid members across the key plan traits, specifically Medicaid dominant, publicly...
Bertrand, J T; Proffitt, B J; Bartlett, T L
The health care profession is witnessing a shift in focus from the interests and needs of the service provider to those of the potential consumer in an effort to attract and maintain clients. This study illustrates the role that marketing research can play in the development of program strategies, even for relatively small organizations. The study was conducted for Planned Parenthood of Louisiana, a recently organized affiliate that began offering clinical services in May 1984, to provide information on the four Ps of marketing: product, price, place, and promotion. Data from telephone interviews among a random sample of 1,000 women 15-35 years old in New Orleans before the clinic opened confirmed that the need for family planning services was not entirely satisfied by existing service providers. Moreover, it indicated that clinic hours and the cost of services were in line with client interests. The most useful findings for developing the promotional strategy were the relatively low name recognition of Planned Parenthood and a higher-than-expected level of interest that young, low income blacks expressed in using the service. PMID:3112854
Bertrand, J T; Proffitt, B J; Bartlett, T L
The health care profession is witnessing a shift in focus from the interests and needs of the service provider to those of the potential consumer in an effort to attract and maintain clients. This study illustrates the role that marketing research can play in the development of program strategies, even for relatively small organizations. The study was conducted for Planned Parenthood of Louisiana, a recently organized affiliate that began offering clinical services in May 1984, to provide information on the four Ps of marketing: product, price, place, and promotion. Data from telephone interviews among a random sample of 1,000 women 15-35 years old in New Orleans before the clinic opened confirmed that the need for family planning services was not entirely satisfied by existing service providers. Moreover, it indicated that clinic hours and the cost of services were in line with client interests. The most useful findings for developing the promotional strategy were the relatively low name recognition of Planned Parenthood and a higher-than-expected level of interest that young, low income blacks expressed in using the service.
Ameri, Cinzia; Fiorini, Fulvio
The gradual emergence of marketing activities in public health demonstrates an increased interest in this discipline, despite the lack of an adequate and universally recognized theoretical model. For a correct approach to marketing techniques, it is opportune to start from the health service, meant as a service rendered. This leads to the need to analyse the salient features of the services. The former is the intangibility, or rather the ex ante difficulty of making the patient understand the true nature of the performance carried out by the health care worker. Another characteristic of all the services is the extreme importance of the regulator, which means who performs the service (in our case, the health care professional). Indeed the operator is of crucial importance in health care: being one of the key issues, he becomes a part of the service itself. Each service is different because the people who deliver it are different, furthermore there are many variables that can affect the performance. Hence it arises the difficulty in measuring the services quality as well as in establishing reference standards.
Hauff, Alicia J; Secor-Turner, Molly
The effects of homelessness on health are well documented, although less is known about the challenges of health care delivery from the perspective of service providers. Using data from a larger health needs assessment, the purpose of this study was to describe homeless health care needs and barriers to access utilizing qualitative data collected from shelter staff (n = 10) and health service staff (n = 14). Shelter staff members described many unmet health needs and barriers to health care access, and discussed needs for other supportive services in the area. Health service providers also described multiple health and service needs, and the need for a recuperative care setting for this population. Although a variety of resources are currently available for homeless health service delivery, barriers to access and gaps in care still exist. Recommendations for program planning are discussed and examined in the context of contributing factors and health care reform.
McHugh, S M; Tyrrell, E; Johnson, B; Healy, O; Perry, I J; Normand, C
This article aims to estimate the workforce and resource implications of the proposed age extension of the national breast screening programme, under the economic constraints of reduced health budgets and staffing levels in the Irish health system. Using a mixed method design, a purposive sample of 20 participants were interviewed and data were analysed thematically (June-September 2012). Quantitative data (programme-level activity data, screening activity, staffing levels and screening plans) were used to model potential workload and resource requirements. The analysis indicates that over 90% operational efficiency was achieved throughout the first six months of 2012. Accounting for maternity leave (10%) and sick leave (3.5%), 16.1 additional radiographers (whole time equivalent) would be required for the workload created by the age extension of the screening programme, at 90% operational efficiency. The results suggest that service expansion is possible with relatively minimal additional radiography resources if the efficiency of the skill mix and the use of equipment are improved. Investing in the appropriate skill mix should not be limited to clinical groups but should also include administrative staff to manage and support the service. Workload modelling may contribute to improved health workforce planning and service efficiency.
US Fish and Wildlife Service, Department of the Interior — This Health and Safety Plan (HASP) applies to all U.S. Fish and Wildlife Service (Service) personnel including employees, graduate students, and volunteers on the...
Ethiopian Journal of Health Development ... Background: The unmet need for family planning services in Ethiopia is believed to ... It is thus expected that an assessment and improvement of the quality of family planning services could enhance ... About 98.5% of the clients were not asked about STD risk and only 3.0% of the ...
Kogi-Makau, Wambui; Tibaijuka, G.M.; Mtawali, Grace; Rose, Mapunda
This report is based on a study, implemented in Kasulu and Kibondo districts in Kigoma Region, Tanzania, to assess the impact of a health attendants’ pilot training strategy on reproductive and child health (RCH) services. The strategy was developed and implemented by the RCH-Unit of Ministry of Health (MOH) with technical assistance from Intrah/PRIME and was implemented with financial support from USAID. The training strategy, covering a period of four months (July to October, 1998), used a ...
Breuer, Erica; De Silva, Mary J; Shidaye, Rahul; Petersen, Inge; Nakku, Juliet; Jordans, Mark J D; Fekadu, Abebaw; Lund, Crick
There is little practical guidance on how contextually relevant mental healthcare plans (MHCPs) can be developed in low-resource settings. To describe how theory of change (ToC) was used to plan the development and evaluation of MHCPs as part of the PRogramme for Improving Mental health carE (PRIME). ToC development occurred in three stages: (a) development of a cross-country ToC by 15 PRIME consortium members; (b) development of country-specific ToCs in 13 workshops with a median of 15 (interquartile range 13-22) stakeholders per workshop; and (c) review and refinement of the cross-country ToC by 18 PRIME consortium members. One cross-country and five district ToCs were developed that outlined the steps required to improve outcomes for people with mental disorders in PRIME districts. ToC is a valuable participatory method that can be used to develop MHCPs and plan their evaluation. © The Royal College of Psychiatrists 2016.
Blonna, R; McNally, K; Grasso, C
To increase public awareness of family planning services in New Jersey, the Family Planning Program of the State Department of Health conducted an intermediary marketing campaign using free public service advertising on mass transit. In 1986, the year of the campaign, 237 calls were made to the advertised hotline, resulting in a like number of referrals to family planning service providers. Also, 2664 new patients examined in the state's family planning agencies in 1986 cited exposure to the media campaign as the reason for their visits. The results of the campaign and their implications for other public service agencies are discussed.
Bin Mohammed, A; Abdul Raheem, K P; Kaivalyam, K
The Ayurvedic manuscript was first composed in Sanskrit by Agnivesha, an individual who lived sometime before 750 B.C. The Ayurveda contains instructions on how to live in order to prevent the occurrence of sickness and how to cure it, if illness arises. The medical work of Ayurveda is comprised of elements of Physiology, Pathology, Pharmacology, Materia Medica, and Surgery, among others. It originally consisted of 100 sections each with 1000 stanzas comprising up to 100,000 verses in eight books. All recent medical works on Ayurveda are based upon the writings of Charaka and Sushruta, who rearranged the books into chapters on surgery, nosology, anatomy, therapeutics, toxicology, and local diseases. The authors explain the use of traditional medicine for health and family planning, and the extent of self-medication in sections on the role of Ayurvedic medicine for health, clinics and medical centers on Ayurveda in Malaysia, oleo-therapy/massage through the application of medicated oil and liniment, institutions and laboratories, research, the extent of self-medication, family planning, and Malaysian Ayurvedic or the Siddha practice of contraception.
School health services reduce absenteeism and improve academic achievement according to research. If you have school-aged children, youâll want to listen to this podcast to learn more about healthy school environments and the link between health and academic achievement. Created: 9/13/2017 by National Center for Chronic Disease Prevention and Health Promotion (NCCDPHP). Date Released: 9/13/2017.
US Fish and Wildlife Service, Department of the Interior — The Visitor Services Plan covers background information, objectives, strategies and goals of the Visitor Services program at Seney NWR for the next 15 years. It...
Fiifi Amoako Johnson
Full Text Available The Community-based Health Planning and Services (CHPS initiative is a major government policy to improve maternal and child health and accelerate progress in the reduction of maternal mortality in Ghana. However, strategic intelligence on the impact of the initiative is lacking, given the persistant problems of patchy geographical access to care for rural women. This study investigates the impact of proximity to CHPS on facilitating uptake of skilled birth care in rural areas.Data from the 2003 and 2008 Demographic and Health Survey, on 4,349 births from 463 rural communities were linked to georeferenced data on health facilities, CHPS and topographic data on national road-networks. Distance to nearest health facility and CHPS was computed using the closest facility functionality in ArcGIS 10.1. Multilevel logistic regression was used to examine the effect of proximity to health facilities and CHPS on use of skilled care at birth, adjusting for relevant predictors and clustering within communities. The results show that a substantial proportion of births continue to occur in communities more than 8 km from both health facilities and CHPS. Increases in uptake of skilled birth care are more pronounced where both health facilities and CHPS compounds are within 8 km, but not in communities within 8 km of CHPS but lack access to health facilities. Where both health facilities and CHPS are within 8 km, the odds of skilled birth care is 16% higher than where there is only a health facility within 8km.Where CHPS compounds are set up near health facilities, there is improved access to care, demonstrating the facilitatory role of CHPS in stimulating access to better care at birth, in areas where health facilities are accessible.
... Internal Revenue Service 26 CFR Part 54 RIN 1545-BJ58 Requirements for Group Health Plans and Health... Center for Consumer Information & Insurance Oversight of the U.S. Department of Health and Human Services... with respect to group health plans and health insurance coverage offered in connection with a group...
Abamecha, Fira; Godesso, Ameyu; Girma, Eshetu
Background To endorse involvement in voluntary HIV counseling and testing (VCT), it is essential to recognize factors that influence people in deciding whether to access VCT services and their underlying route factors. Theory of planned behavior (TPB) constitutes a proficient framework for predicting behaviors and intentions. Objective The aim of the study reported here was to assess the predicting ability of TPB in determining the intended use of VCT services among health professionals in Jimma, southwest Ethiopia. Methods This was an institution-based cross-sectional quantitative study of a sample of 336 health professionals in 12 selected districts of Jimma, southwest Ethiopia between February 5 to March 28, 2012. Data were collected using structured questionnaire self-administered by the study participants. A hierarchal multivariable linear regression model was used to predict the role of TPB constructs that can influence the intention to use VCT services. Results The constructs of TPB explained the variability in intention to use VCT by 27% (R2 adjusted = 0.27). The standardized regression coefficients showed that the strongest predictor of intention to use VCT was subjective norms (β = 0.32, P behavioral control was not a significant predictor of intention to use VCT among the study group (P = 0.12). Conclusion The study revealed the possibility of describing the intention to use VCT among health professionals using TPB, with perceived social pressure being the leading predictor. In light of this, health intervention programs should be designed to develop health professionals’ ability to resist norms that oppose the use of VCT and to change community-held norms against VCT use, provided they help individuals develop a positive attitude toward the services. PMID:24143111
Level: Formative Assessment with Village Health Teams in Uganda. Aurélie Brunie. 1 ... Little is known on integrating HIV and family planning (FP) services in community settings. Using a cluster ..... the risk of unplanned pregnancy and HIV.
Sakeah, Evelyn; McCloskey, Lois; Bernstein, Judith; Yeboah-Antwi, Kojo; Mills, Samuel; Doctor, Henry V
In Ghana, between 1,400 and 3,900 women and girls die annually due to pregnancy related complications and an estimated two-thirds of these deaths occur in late pregnancy through to 48 hours after delivery. The Ghana Health Service piloted a strategy that involved training Community Health Officers (CHOs) as midwives to address the gap in skilled attendance in rural Upper East Region (UER). CHO-midwives collaborated with community members to provide skilled delivery services in rural areas. This paper presents findings from a study designed to assess the extent to which community residents and leaders participated in the skilled delivery program and the specific roles they played in its implementation and effectiveness. We employed an intrinsic case study design with a qualitative methodology. We conducted 29 in-depth interviews with health professionals and community stakeholders. We used a random sampling technique to select the CHO-midwives in three Community-based Health Planning and Services (CHPS) zones for the interviews and a purposive sampling technique to identify and interview District Directors of Health Services from the three districts, the Regional Coordinator of the CHPS program and community stakeholders. Community members play a significant role in promoting skilled delivery care in CHPS zones in Ghana. We found that community health volunteers and traditional birth attendants (TBAs) helped to provide health education on skilled delivery care, and they also referred or accompanied their clients for skilled attendants at birth. The political authorities, traditional leaders, and community members provide resources to promote the skilled delivery program. Both volunteers and TBAs are given financial and non-financial incentives for referring their clients for skilled delivery. However, inadequate transportation, infrequent supply of drugs, attitude of nurses remains as challenges, hindering women accessing maternity services in rural areas. Mutual
... Revenue Service 26 CFR Part 54 RIN 1545-BJ50 Group Health Plans and Health Insurance Coverage Rules... respect to group health plans and health insurance coverage offered in connection with a group health plan... temporary regulations provide guidance to employers, group health plans, and health insurance issuers...
Oversight on Family Planning Programs under Title X of the Public Health Service Act, 1984. Hearings before the Subcommittee on Family and Human Services of the Committee on Labor and Human Resources. United States Senate, Ninety-Eighth Congress, Second Session on Consideration of the Reauthorization of Title X of the Public Health Service Act, the Population Research and Voluntary Family Planning Programs (April 5 and May 1, 1984).
Congress of the U.S., Washington, DC. Senate Committee on Labor and Human Resources.
This document provides witness testimony and prepared statements from two sessions of the congressional hearing called to consider the reauthorization of Title X of the Public Health Service Act, the Population Research and Voluntary Family Planning Programs. Testimony is provided from the federal administration, state officials, representatives…
Robles, Enrique Camarena; Belfort, Edgard G
The history of mental health services in Latin America, has been influenced by public policies derived from governments in turn, in each one of the countries of the region. As much in the definition of these public policies, as in the resource allocation, the rule has been inconsistency and indifference. The few results have been dependent on the decision of one or just a few people who were able to make decisions in local and regional Latin American governments. A brief analysis regarding the role and transformation of psychiatric hospitals can be found in this article, also of the workers attitudes and ideology, as well as the importance of developing better mental health professionals with knowledge of public administration and particularly in well-known strategies such as strategic planning.
... HUMAN SERVICES Centers for Disease Control and Prevention Draft Public Health Action Plan--A National Public Health Action Plan for the Detection, Prevention, and Management of Infertility AGENCY: Centers... requesting public comment on the draft National Public Health Action Plan for the Detection, Prevention,...
... HUMAN SERVICES Centers for Disease Control and Prevention Draft Public Health Action Plan--A National Public Health Action Plan for the Detection, Prevention, and Management of Infertility AGENCY: Centers... Federal Register requesting public comment on the draft National Public Health Action Plan for...
... ADMINISTRATION Service Delivery Plan AGENCY: Social Security Administration (SSA). ACTION: Notice; request for comments. SUMMARY: We are requesting public input as we finalize our Service Delivery Plan (SDP). We... Nation's economy. Today, the challenge of service delivery is greater than at any other point in...
Griffith, Jennifer M; Kay Carpender, S; Crouch, Jill Artzberger; Quiram, Barbara J
The Texas A&M Health Science Center School of Rural Public Health, a member of the Training and Education Collaborative System Preparedness and Emergency Response Learning Center (TECS-PERLC), has long-standing partnerships with 2 Health Service Regions (Regions) in Texas. TECS-PERLC was contracted by these Regions to address 2 challenges identified in meeting requirements outlined by the Risk-Based Funding Project. First, within Metropolitan Statistical Areas, there is not a formal authoritative structure. Second, preexisting tools and processes did not adequately satisfy requirements to assess public health, medical, and mental health needs and link mitigation strategies to the Public Health Preparedness Capabilities, which provide guidance to prepare for, respond to, and recover from public health incidents. TECS-PERLC, with its partners, developed a framework to interpret and apply results from the Texas Public Health Risk Assessment Tool (TxPHRAT). The 3-phase community engagement-based TxPHRAT Mitigation Planning Process (Mitigation Planning Process) and associated tools facilitated the development of mitigation plans. Tools included (1) profiles interpreting TxPHRAT results and identifying, ranking, and prioritizing hazards and capability gaps; (2) a catalog of intervention strategies and activities linked to hazards and capabilities; and (3) a template to plan, evaluate, and report mitigation planning efforts. The Mitigation Planning Process provided a framework for Regions to successfully address all funding requirements. TECS-PERLC developed more than 60 profiles, cataloged and linked 195 intervention strategies, and developed a template resulting in 20 submitted mitigation plans. A public health-focused, community engagement-based mitigation planning process was developed by TECS-PERLC and successfully implemented by the Regions. The outcomes met all requirements and reinforce the effectiveness of academic practice partnerships and importance of
Van Doren, D C; Durney, J R; Darby, C M
The scope of geriatric services offered by health care institutions has expanded from the traditional hospital, long-term care, and home care services to include a variety of community services in an effort to promote the institution and provide a continuum of care for the elderly. The purposes of this article are to analyze why marketing of geriatric services is such a significant issue in health care today, to identify why a comprehensive management tool such as Service Line Management may be a key component for successful development and marketing of geriatric services, and to analyze the key decisions facing management when formulating a marketing plan.
Lystbæk, Christian Tang
Technology developments create rich opportunities for health service providers to introduce service robots in health care. While the potential benefits of applying robots in health care are extensive, the research into the conceptions of health service robot and its importance for the uptake...... of robotics technology in health care is limited. This article develops a model of the basic conceptions of health service robots that can be used to understand different assumptions and values attached to health care technology in general and health service robots in particular. The article takes...... a discursive approach in order to develop a conceptual framework for understanding the social values of health service robots. First a discursive approach is proposed to develop a typology of conceptions of health service robots. Second, a model identifying four basic conceptions of health service robots...
Evaluation of HACCP plans of food industries: case study conducted by the Servizio di Igiene degli Alimenti e della Nutrizione (Food and Nutrition Health Service) of the local health authority of Foggia, Italy.
Panunzio, Michele F; Antoniciello, Antonietta; Pisano, Alessandra; Rosa, Giovanna
With respect to food safety, many works have studied the effectiveness of self-monitoring plans of food companies, designed using the Hazard Analysis and Critical Control Point (HACCP) method. On the other hand, indepth research has not been made concerning the adherence of the plans to HACCP standards. During our research, we evaluated 116 self-monitoring plans adopted by food companies located in the territory of the Local Health Authority (LHA) of Foggia, Italy. The general errors (terminology, philosophy and redundancy) and the specific errors (transversal plan, critical limits, hazard specificity, and lack of procedures) were standardized. Concerning the general errors, terminological errors pertain to half the plans examined, 47% include superfluous elements and 60% have repetitive subjects. With regards to the specific errors, 77% of the plans examined contained specific errors. The evaluation has pointed out the lack of comprehension of the HACCP system by the food companies and has allowed the Servizio di Igiene degli Alimenti e della Nutrizione (Food and Nutrition Health Service), in its capacity as a control body, to intervene with the companies in order to improve designing HACCP plans.
Evaluation of HACCP Plans of Food Industries: Case Study Conducted by the Servizio di Igiene degli Alimenti e della Nutrizione (Food and Nutrition Health Service of the Local Health Authority of Foggia, Italy
Full Text Available With respect to food safety, many works have studied the effectiveness of self-monitoring plans of food companies, designed using the Hazard Analysis and Critical Control Point (HACCP method. On the other hand, indepth research has not been made concerning the adherence of the plans to HACCP standards. During our research, we evaluated 116 self-monitoring plans adopted by food companies located in the territory of the Local Health Authority (LHA of Foggia, Italy. The general errors (terminology, philosophy and redundancy and the specific errors (transversal plan, critical limits, hazard specificity, and lack of procedures were standardized. Concerning the general errors, terminological errors pertain to half the plans examined, 47% include superfluous elements and 60% have repetitive subjects. With regards to the specific errors, 77% of the plans examined contained specific errors. The evaluation has pointed out the lack of comprehension of the HACCP system by the food companies and has allowed the Servizio di Igiene degli Alimenti e della Nutrizione (Food and Nutrition Health Service, in its capacity as a control body, to intervene with the companies in order to improve designing HACCP plans.
Full Text Available Fira Abamecha,1 Ameyu Godesso,2 Eshetu Girma3 1Department of Nursing, Mizan-Tepi University, Mizan, 2Department of Sociology, Jimma University, Jimma, 3Department of Health Education and Behavioral Sciences, Jimma University, Jimma, Ethiopia Background: To endorse involvement in voluntary HIV counseling and testing (VCT, it is essential to recognize factors that influence people in deciding whether to access VCT services and their underlying route factors. Theory of planned behavior (TPB constitutes a proficient framework for predicting behaviors and intentions. Objective: The aim of the study reported here was to assess the predicting ability of TPB in determining the intended use of VCT services among health professionals in Jimma, southwest Ethiopia. Methods: This was an institution-based cross-sectional quantitative study of a sample of 336 health professionals in 12 selected districts of Jimma, southwest Ethiopia between February 5 to March 28, 2012. Data were collected using structured questionnaire self-administered by the study participants. A hierarchal multivariable linear regression model was used to predict the role of TPB constructs that can influence the intention to use VCT services. Results: The constructs of TPB explained the variability in intention to use VCT by 27% (R2 adjusted = 0.27. The standardized regression coefficients showed that the strongest predictor of intention to use VCT was subjective norms (β = 0.32, P < 0.0005 followed by attitude (β = 0.21, P < 0.002. Perceived behavioral control was not a significant predictor of intention to use VCT among the study group (P = 0.12. Conclusion: The study revealed the possibility of describing the intention to use VCT among health professionals using TPB, with perceived social pressure being the leading predictor. In light of this, health intervention programs should be designed to develop health professionals’ ability to resist norms that oppose the use of VCT and to
Brittain, Anna W.; Williams, Jessica R.; Zapata, Lauren B.; Moskosky, Susan B.; Weik, Tasmeen S.
Context Family planning services are essential for reducing high rates of unintended pregnancies among young people, yet a perception that providers will not preserve confidentiality may deter youth from accessing these services. This systematic review, conducted in 2011, summarizes the evidence on the effect of assuring confidentiality in family planning services to young people on reproductive health outcomes. The review was used to inform national recommendations on providing quality family planning services. Evidence acquisition Multiple databases were searched to identify articles addressing confidentiality in family planning services to youth aged 10–24 years. Included studies were published from January 1985 through February 2011. Studies conducted outside the U.S., Canada, Europe, Australia, or New Zealand, and those that focused exclusively on HIV or sexually transmitted diseases, were excluded. Evidence synthesis The search strategy identified 19,332 articles, nine of which met the inclusion criteria. Four studies examined outcomes. Examined outcomes included use of clinical services and intention to use services. Of the four outcome studies, three found a positive association between assurance of confidentiality and at least one outcome of interest. Five studies provided information on youth perspectives and underscored the idea that young people greatly value confidentiality when receiving family planning services. Conclusions This review demonstrates that there is limited research examining whether confidentiality in family planning services to young people affects reproductive health outcomes. A robust research agenda is needed, given the importance young people place on confidentiality. PMID:26190851
Yalew, Saleamlak Adbaru; Zeleke, Berihun Megabiaw; Teferra, Alemayehu Shimeka
Demand for long acting contraceptive methods is one of the key factors for total fertility rate and reproductive health issues. Increased demand for these methods can decline fertility rate through spacing and limiting family size in turn improving maternal and family health and socioeconomic development of a country. The aim of this study was to assess demand for long acting contraceptives and associated factors among family planning users in Debre-Tabor Town, Northwest Ethiopia. Facility based cross-sectional study was conducted from July to August 2013. Data was collected on 487 current family planning users through face to face interview using structured questionnaire. Study participants were selected by systematic sampling method. Data were entered in to Epi Info and analyzed by using SPSS version 20. Bi-variable and multi-variable regression analyses were done to identify factors associated with demand for long acting contraceptive methods. Odds ratio with 95% CI was used to assess the association between the independent variables and demand for long acting family planning methods. The study showed that, demand for long acting contraceptives was 17%. Only 9.2% of the women were using long acting contraceptive methods (met need). About 7.8% of women were using short acting methods while they actually want to use long acting methods (unmet need). Demand for LACMs was positively associated 3 with being a daily labour (AOR = 3.87, 95% CI = [1.06, 14.20]), being a student (AOR = 2.64, 95% CI = [1.27, 5.47]), no future birth intensions (AOR = 2.17, 95% CI = [1.12, 4.23]), having five or more children (AOR = 1.67, 95% CI = [1.58, 4.83]), deciding together with husbands for using the methods (AOR = 2.73, 95% CI = [1.40, 5.32]) and often having discussion with husband (AOR = 3.89, 95% CI = [1.98, 7.65]). Clients treated poorly by the health care providers during taking the services was negatively associated with demand for LACMs (AOR = 0.42, 95% CI = [0.24, 0
Garnick, Deborah W; Horgan, Constance M; Reif, Sharon; Merrick, Elizabeth L; Hodgkin, Dominic
We explored the techniques used by private health plans or by their contracted managed behavioral healthcare organizations (MBHOs) to maintain networks of behavioral health providers. In particular, we focused on differences by health plans' product types (health maintenance organization, point-of-service plan, or preferred provider organization) and contracting arrangements (MBHO contracts, comprehensive contracts, or no contracts). More than 94% of products selected providers using credentialing standards, particular specialists, or geographic coverage. To retain providers viewed as high quality, 54% offer reduced administrative burden and 44% higher fees. Only 16% reported steerage to a core group of highest-quality providers and few reported an annual bonus or guaranteed volume of referrals. Some standard activities are common, but some health plans are adopting other approaches to retain higher-quality providers.
Adaptation of Impact Questions from an Existing Toolkit Provided Clear Assessment of Valued Service Elements and Desirable Service Improvements in a Primary Health Care Library and Information Service. A Review of: Urquhart, C., Thomas, R., Ovens, J., Lucking, W., & Villa, J. (2010. Planning changes to health library services on the basis of impact assessment. Health Information and Libraries Journal, 27(4, 277-285. doi: 10.1111/j.1471-1842.2010.00900.x
Full Text Available Objective – To provide an action plan for the Knowledge, Resource and Information Service (KRIS based on an impact assessment of current services, satisfaction with current services, and views on desirable improvements to service and service delivery.Design – Questionnaire for KRIS service users and interviews with KRIS staff.Setting – Two locations served by KRIS in the north and south of Bristol City in the UK – one a health promotion service and one a National Health Service (NHS teaching hospital.Subjects – A convenience sample of a total of 244 users of the library services at the two locations, 121 users at the health promotion service site and 123 users at the hospital site.Methods – A questionnaire designed for a previous NHS library service impact study was adapted for use with staff other than health workers, since teachers and youth workers, for example, also used the health promotion service. The researchers circulated the questionnaire by mail and email to prospective respondents. The questionnaire asked participants to reflect on the most recent time they had used KRIS services and provide details on the purpose of use, what elements of the service they used, satisfaction with the service or the information provided, the immediate impact on their work, and its probable contribution to future work. It also asked about desirable improvements and how KRIS contributed to the respondents’ work and continuing professional development. The researchers interviewed KRIS staff face to face and asked for their views on the history of the service and future developments.Main Results – The overall response rate was 62.3% (152/244, with similar responses from each site. Community nurses and midwives were the largest group of respondents (n=31, 20.4%, followed by managers and administrators (n=24, 15.8%.Both sites reported health promotion activities as the dominant reason for use. Health promotion leaflets (n=94, 61.8% and
Thomas, Christopher R; Penn, Joseph V
As the second century of partnership begins, child psychiatry and juvenile justice face continuing challenges in meeting the mental health needs of delinquents. The modern juvenile justice system is marked by a significantly higher volume of cases, with increasingly complicated multiproblem youths and families with comorbid medical, psychiatric, substance abuse disorders, multiple family and psychosocial adversities, and shrinking community resources and alternatives to confinement. The family court is faced with shrinking financial resources to support court-ordered placement and treatment programs in efforts to treat and rehabilitate youths. The recognition of high rates of mental disorders for incarcerated youth has prompted several recommendations for improvement and calls for reform [56,57]. In their 2000 annual report, the Coalition for Juvenile Justice advocated increased access to mental health services that provide a continuum of care tailored to the specific problems of incarcerated youth . The specific recommendations of the report for mental health providers include the need for wraparound services, improved planning and coordination between agencies, and further research. The Department of Justice, Office of Juvenile Justice and Delinquency Prevention has set three priorities in dealing with the mental health needs of delinquents: further research on the prevalence of mental illness among juvenile offenders, development of mental health screening assessment protocols, and improved mental health services . Other programs have called for earlier detection and diversion of troubled youth from juvenile justice to mental health systems [31,56]. Most recently, many juvenile and family courts have developed innovative programs to address specific problems such as truancy or substance use and diversionary or alternative sentencing programs to deal with first-time or nonviolent delinquents. All youths who come in contact with the juvenile justice system
... ADMINISTRATION Service Delivery Plan; Correction AGENCY: Social Security Administration. ACTION: Notice; request... SUMMARY caption insert the following hyper-links. In the first sentence after the words, ``Service Delivery Plan (SDP) insert http://www.ssa.gov/open/SDP . In ] addition, in the third sentence after...
Bohon, Lisa M.; Cotter, Kelly A.; Kravitz, Richard L.; Cello, Philip C.; Fernandez y Garcia, Erik
Background: Between 9.5% and 31.3% of college students suffer from depression ("American college health association national college health assessment II: reference group executive summary spring 2013." "Amer. Coll. Health Assoc." 2013; Eagan K, Stolzenberg EB, Ramirez JJ, Aragon, MC, Suchard, RS, Hurtado S. "The American…
Bohon, Lisa M.; Cotter, Kelly A.; Kravitz, Richard L.; Cello, Philip C.; Fernandez y Garcia, Erik
Background: Between 9.5% and 31.3% of college students suffer from depression ("American college health association national college health assessment II: reference group executive summary spring 2013." "Amer. Coll. Health Assoc." 2013; Eagan K, Stolzenberg EB, Ramirez JJ, Aragon, MC, Suchard, RS, Hurtado S. "The American…
Full Text Available Charles Ruetsch,1 Joseph Tkacz,1 Peter G Kardel,1 Andrew Howe,2 Helen Pai,2 Bennett Levitan31Health Analytics, LLC, Columbia, Maryland, 2Janssen Research & Development, Raritan, New Jersey, 3Janssen Research & Development, Titusville, New Jersey, USAIntroduction: The lack of consistency surrounding the diagnosis of chronic non-cancer pain, treatment approaches, and patient management suggests the need for further research to better characterize the chronic non-cancer pain population.Objective: The purpose of this study was to identify distinct trajectories of health care service utilization of chronic non-cancer pain patients and describe the characteristic differences between trajectory groups.Patients and methods: This study utilized the MarketScan claims databases. A total of 71,392 patients diagnosed with either low back pain or osteoarthritis between 2006 and 2009 served as the study sample. Each subject's claims data were divided into three time periods around an initial diagnosis date: pre-period, post-Year 1, and post-Year 2. Subjects were categorized as either high (H or low (L cost at each post period, resulting in the creation of four trajectory groups based on the post-Year 1 and 2 cost pattern: H-H, H-L, L-H, and L-L. Multivariate statistical tests were used to predict and discriminate between trajectory group memberships.Results: The H-H, L-H, and H-L groups each utilized significantly greater pre-period high-cost venue services, post-Year 1 outpatient services, and post-Year 1 opioids compared to the L-L group (P <0.001. Additionally, the H-H and L-H groups displayed elevated Charlson comorbidity index scores compared with the L-L group (P <0.001, with each showing increased odds of having both opioid dependence and cardiovascular disease diagnoses (P <0.01.Conclusion: This study identified patient characteristics among chronic pain patients that discriminated between different levels of post-index high-cost venue service
Larisa Vulakh, Student Pharmacist; Albert I. Wertheimer, PhD, MBA
The objective of this study was to describe and compare prescription drug costs charged to a plan sponsor for the top 50 maintenance medications provided through retail and mail service procurement channels. Data were obtained for covered beneficiaries of a health plan sponsored by an employer with just over 3,000 covered employees The analytics team at the PBM administering the plan sponsor’s prescription drug benefit provided de-identified claims information for the top 50 maintenance presc...
What we know today as Health Services is a fiction, perhaps shaped involuntarily, but with deep health repercussions, more negative than positive. About 24 centuries ago, Asclepius, god of medicine, and Hygeia, goddess of hygiene and health, generated a dichotomy between disease and health that remains with us until today. The confusing substitution of Health Services with Medical Services began toward the end of the XIX century. But it was in 1948 when the so called English National Health Service became a landmark in the world with its model being adopted by many countries with resulting distortion of the true meaning of Health Services. The consequences of this fiction have been ominous. It is necessary to call things by their names and not deceive society. To correct the serious imbalance between Medical Services and Health Services, Hygeia and Asclepius must become a brother and sisterhood. PMID:24893062
Full Text Available Background: The German statutory health insurance (GKV reimburses all health care services that are deemed sufficient, appropriate, and efficient. According to the German Medical Association (BÄK, individual health services (IGeL are services that are not under liability of the GKV, medically necessary or recommendable or at least justifiable. They have to be explicitly requested by the patient and have to be paid out of pocket. Research questions: The following questions regarding IGeL in the outpatient health care of GKV insurants are addressed in the present report: What is the empirical evidence regarding offers, utilization, practice, acceptance, and the relation between physician and patient, as well as the economic relevance of IGeL? What ethical, social, and legal aspects are related to IGeL? For two of the most common IGeL, the screening for glaucoma and the screening for ovarian and endometrial cancer by vaginal ultrasound (VUS, the following questions are addressed: What is the evidence for the clinical effectiveness? Are there sub-populations for whom screening might be beneficial? Methods: The evaluation is divided into two parts. For the first part a systematic literature review of primary studies and publications concerning ethical, social and legal aspects is performed. In the second part, rapid assessments of the clinical effectiveness for the two examples, glaucoma and VUS screening, are prepared. Therefore, in a first step, HTA-reports and systematic reviews are searched, followed by a search for original studies published after the end of the research period of the most recent HTA-report included. Results: 29 studies were included for the first question. Between 19 and 53% of GKV members receive IGeL offers, of which three-quarters are realised. 16 to 19% of the insurants ask actively for IGeL. Intraocular tension measurement is the most common single IGeL service, accounting for up to 40% of the offers. It is followed by
Katzenellenbogen, Judith M; Miller, Laura J; Somerford, Peter; McEvoy, Suzanne; Bessarab, Dawn
The aim of the present study was to provide descriptive planning data for a hospital-based Aboriginal Health Liaison Officer (AHLO) program, specifically quantifying episodes of care and outcomes within 28 days after discharge. A follow-up study of Aboriginal in-patient hospital episodes was undertaken using person-based linked administrative data from four South Metropolitan hospitals in Perth, Western Australia (2006-11). Outcomes included 28-day deaths, emergency department (ED) presentations and in-patient re-admissions. There were 8041 eligible index admissions among 5113 individuals, with episode volumes increasing by 31% over the study period. Among patients 25 years and older, the highest ranking comorbidities included injury (47%), drug and alcohol disorders (41%), heart disease (40%), infection (40%), mental illness (31%) and diabetes (31%). Most events (96%) ended in a regular discharge. Within 28 days, 24% of events resulted in ED presentations and 20% resulted in hospital readmissions. Emergency readmissions (13%) were twice as likely as booked re-admissions (7%). Stratified analyses showed poorer outcomes for older people, and for emergency and tertiary hospital admissions. Future planning must address the greater service volumes anticipated. The high prevalence of comorbidities requires intensive case management to address case complexity. These data will inform the refinement of the AHLO program to improve in-patient experiences and outcomes.
Borges, Ana Luiza Vilela; OlaOlorun, Funmilola; Fujimori, Elizabeth; Hoga, Luiza Akiko Komura; Tsui, Amy Ong
Although it is well known that post-abortion contraceptive use is high when family planning services are provided following spontaneous or induced abortions, this relationship remains unclear in Brazil and similar settings with restrictive abortion laws. Our study aims to assess whether contraceptive use is associated with access to family planning services in the six-month period post-abortion, in a setting where laws towards abortion are highly restrictive. This prospective cohort study recruited 147 women hospitalized for emergency treatment following spontaneous or induced abortion in Brazil. These women were then followed up for six months (761 observations). Women responded to monthly telephone interviews about contraceptive use and the utilization of family planning services (measured by the utilization of medical consultation and receipt of contraceptive counseling). Generalized Estimating Equations were used to analyze the effect of family planning services and other covariates on contraceptive use over the six-month period post-abortion. Women who reported utilization of both medical consultation and contraceptive counseling in the same month had higher odds of reporting contraceptive use during the six-month period post-abortion, when compared with those who did not use these family planning services [adjusted aOR = 1.93, 95 % Confidence Interval: 1.13-3.30]. Accessing either service alone did not contribute to contraceptive use. Age (25-34 vs. 15-24 years) was also statistically associated with contraceptive use. Pregnancy planning status, desire to have more children and education did not contribute to contraceptive use. In restrictive abortion settings, family planning services offered in the six-month post-abortion period contribute to contraceptive use, if not restricted to simple counseling. Medical consultation, in the absence of contraceptive counseling, makes no difference. Immediate initiation of a contraceptive that suits women's pregnancy
... Internal Revenue Service 26 CFR Part 54 RIN 1545-BJ50 Group Health Plans and Health Insurance Coverage... provide guidance to employers, group health plans, and health insurance issuers providing group health... Insurance Oversight of the U.S. Department of Health and Human Services are issuing substantially similar...
Moazzez, Ashkan; de Virgilio, Christian
With constant changes in health-care laws and payment methods, profitability, and financial sustainability of hospitals are of utmost importance. The purpose of this study is to determine the relationship between surgical services and hospital profitability. The Office of Statewide Health Planning and Development annual financial databases for the years 2009 to 2011 were used for this study. The hospitals' characteristics and income statement elements were extracted for statistical analysis using bivariate and multivariate linear regression. A total of 989 financial records of 339 hospitals were included. On bivariate analysis, the number of inpatient and ambulatory operating rooms (ORs), the number of cases done both as inpatient and outpatient in each OR, and the average minutes used in inpatient ORs were significantly related with the net income of the hospital. On multivariate regression analysis, when controlling for hospitals' payer mix and the study year, only the number of inpatient cases done in the inpatient ORs (β = 832, P = 0.037), and the number of ambulatory ORs (β = 1,485, 466, P = 0.001) were significantly related with the net income of the hospital. These findings suggest that hospitals can maximize their profitability by diverting and allocating outpatient surgeries to ambulatory ORs, to allow for more inpatient surgeries.
... Group Health Plans and Health Insurance Coverage Relating to Status as a Grandfathered Health Plan Under... and Insurance Oversight, Department of Health and Human Services. ACTION: Amendment to interim final... regulations implementing the rules for group health plans and health insurance coverage in the group and...
... Revenue Service 26 CFR Part 54 RIN 1545-BJ45 Group Health Plans and Health Insurance Issuers Providing... Labor and the Office of Consumer Information and Insurance Oversight of the U.S. Department of Health... health plans and health insurance coverage offered in connection with a group health plan under the...
US Fish and Wildlife Service, Department of the Interior — This document contains 3 major plans including the Habitat Management Plan, the Integrated Pest Management Plan and the Visitor Services Plan. These plans provide...
Krakauer, R S
It is important that physicians participate in the debate and planning process that will ultimately guide how we reform the way health care is financed and delivered in the United States. Herein is offered a perspective on the problem, one which is not necessarily appreciated by health planners. While we deliver the best quality of care in the world to most of our population, our system has been severely criticized because we fail to provide for access to a substantial minority of our population. Additionally, the cost of the product is considerably greater than that in comparable countries. Attempts to control costs without diminishing quality have introduced expensive complexities into our system without any real success in cutting costs. Several proposals have been advanced to address the issues of cost and access. One of these is a single payer system, common in Europe and Canada, whereby a single agent or group of agents finances all health care through universal rules and means. A system operating in Hawaii is a simple employer mandate to provide health insurance. A uniquely American plan is the Jackson Hole Plan or Managed Competition (now called "Managed Cooperation"). This system is currently popular among national health planners, and involves a defined minimum managed health plan offered by various groups of providers to employees and individuals through health plan purchasing cooperatives. This plan is interesting, but has not been implemented in any jurisdiction, and it is not certain it would accomplish its goals in practice since it is difficult to predict behavior of all parties to such a system.
...) Deliver quality disability decisions and services; (2) provide quality service to the public; (3) preserve... significantly to the Nation's economy. As we develop our plan, we are interested in hearing from you, our... responding to requests for verifying benefit amounts and assisting people with claims for other Federal...
Mousseau, J.; Magleby, M.; Litus, M.
Recurring waste management noncompliance problems have spurred a fundamental site-wide process revision to characterize and disposition wastes at the Idaho National Engineering and Environmental Laboratory. The reengineered method, termed Waste Generator Services, will streamline the waste acceptance process and provide waste generators comprehensive waste management services through a single, accountable organization to manage and disposition wastes in a timely, cost-effective, and compliant manner. This report outlines the strategy for implementing Waste Generator Services across the INEEL. It documents the culmination of efforts worked by the LMITCO Environmental Management Compliance Reengineering project team since October 1997. These efforts have included defining problems associated with the INEEL waste management process; identifying commercial best management practices; completing a review of DOE Complex-wide waste management training requirements; and involving others through an Integrated Process Team approach to provide recommendations on process flow, funding/charging mechanisms, and WGS organization. The report defines the work that will be performed by Waste Generator Services, the organization and resources, the waste acceptance process flow, the funding approach, methods for measuring performance, and the implementation schedule and approach. Field deployment will occur first at the Idaho Chemical Processing Plant in June 1998. Beginning in Fiscal Year 1999, Waste Generator Services will be deployed at the other major INEEL facilities in a phased approach, with implementation completed by March 1999.
Merlino, James I; Raman, Ananth
The Cleveland Clinic has long had a reputation for medical excellence. But in 2009 the CEO acknowledged that patients did not think much of their experience there and decided to act. Since then the Clinic has leaped to the top tier of patient-satisfaction surveys, and it now draws hospital executives from around the world who want to study its practices. The Clinic's journey also holds Lessons for organizations outside health care that must suddenly compete by creating a superior customer experience. The authors, one of whom was critical to steering the hospital's transformation, detail the processes that allowed the Clinic to excel at patient satisfaction without jeopardizing its traditional strengths. Hospital leaders: Publicized the problem internally. Seeing the hospital's dismal service scores shocked employees into recognizing that serious flaws existed. Worked to understand patients' needs. Management commissioned studies to get at the root causes of dissatisfaction. Made everyone a caregiver. An enterprisewide program trained everyone, from physicians to janitors, to put the patient first. Increased employee engagement. The Clinic instituted a "caregiver celebration" program and redoubled other motivational efforts. Established new processes. For example, any patient, for any reason, can now make a same-day appointment with a single call. Set patients' expectations. Printed and online materials educate patients about their stays--before they're admitted. Operating a truly patient-centered organization, the authors conclude, isn't a program; it's a way of life.
Kochtitzky, Chris S; Frumkin, H; Rodriguez, R; Dannenberg, A L; Rayman, J; Rose, K; Gillig, R; Kanter, T
Urban planning, also called city and regional planning, is a multidisciplinary field in which professionals work to improve the welfare of persons and communities by creating more convenient, equitable, healthful, efficient, and attractive places now and for the future. The centerpiece of urban planning activities is a "master plan," which can take many forms, including comprehensive plans, neighborhood plans, community action plans, regulatory and incentive strategies, economic development plans, and disaster preparedness plans. Traditionally, these plans include assessing and planning for community needs in some or all of the following areas: transportation, housing, commercial/office buildings, natural resource utilization, environmental protection, and health-care infrastructure. Urban planning and public health share common missions and perspectives. Both aim to improve human well-being, emphasize needs assessment and service delivery, manage complex social systems, focus at the population level, and rely on community-based participatory methods. Both fields focus on the needs of vulnerable populations. Throughout their development, both fields have broadened their perspectives. Initially, public health most often used a biomedical model (examining normal/abnormal functioning of the human organism), and urban planning often relied on a geographic model (analysis of human needs or interactions in a spatial context). However, both fields have expanded their tools and perspectives, in part because of the influence of the other. Urban planning and public health have been intertwined for most of their histories. In 1854, British physician John Snow used geographic mapping of an outbreak of cholera in London to identify a public water pump as the outbreak's source. Geographic analysis is a key planning tool shared by urban planning and public health. In the mid-1800s, planners such as Frederick Law Olmsted bridged the gap between the fields by advancing the concept
Bond, Alan, E-mail: firstname.lastname@example.org [InteREAM (Interdisciplinary Research in Environmental Assessment and Management), School of Environmental Sciences, University of East Anglia, Norwich, NR4 7TJ (United Kingdom); Cave, Ben, E-mail: email@example.com [Ben Cave Associates Ltd., Leeds (United Kingdom); Ballantyne, Rob, E-mail: firstname.lastname@example.org [Planning and Health Consultant, Oxfordshire (United Kingdom)
This study examines whether there is active planning for health improvement in the English spatial planning system and how this varies across two regions using a combination of telephone surveys and focus group interviews in 2005 and 2010. The spatial planning profession was found to be ill-equipped to consider the health and well-being implications of its actions, whilst health professionals are rarely engaged and have limited understanding and aspirations when it comes to influencing spatial planning. Strategic Environmental Assessment was not considered to be successful in integrating health into spatial plans, given it was the responsibility of planners lacking the capacity to do so. For their part, health professionals have insufficient knowledge and understanding of planning and how to engage with it to be able to plan for health gains rather than simply respond to health impacts. HIA practice is patchy and generally undertaken by health professionals outside the statutory planning framework. Thus, whilst appropriate assessment tools exist, they currently lack a coherent context within which they can function effectively and the implementation of the Kiev protocol requiring the engagement of health professionals in SEA is not to likely improve the consideration of health in planning while there continues to be separation of functions between professions and lack of understanding of the other profession. -- Highlights: ► Health professionals have limited aspirations for health improvement through the planning system. ► Spatial planners are ill-equipped to understand the health and well-being implications of their activities. ► SEA and HIA currently do not embed health consideration in planning decisions. ► The separation of health and planning functions is problematic for the effective conduct of SEA and/or HIA.
... provide for community health. A variety of programs, disciplines, strategies and interventions work together to pursue the ... Office of Finance and Accounting - 10E54 Office of Human Resources - 11E53A Office of Information Technology - 07E57B Office of ...
Fuller Jeffrey D
Full Text Available Abstract Background Farmers represent a subgroup of rural and remote communities at higher risk of suicide attributed to insecure economic futures, self-reliant cultures and poor access to health services. Early intervention models are required that tap into existing farming networks. This study describes service networks in rural shires that relate to the mental health needs of farming families. This serves as a baseline to inform service network improvements. Methods A network survey of mental health related links between agricultural support, health and other human services in four drought declared shires in comparable districts in rural New South Wales, Australia. Mental health links covered information exchange, referral recommendations and program development. Results 87 agencies from 111 (78% completed a survey. 79% indicated that two thirds of their clients needed assistance for mental health related problems. The highest mean number of interagency links concerned information exchange and the frequency of these links between sectors was monthly to three monthly. The effectiveness of agricultural support and health sector links were rated as less effective by the agricultural support sector than by the health sector (p Conclusion Aligning with agricultural agencies is important to build effective mental health service pathways to address the needs of farming populations. Work is required to ensure that these agricultural support agencies have operational and effective links to primary mental health care services. Network analysis provides a baseline to inform this work. With interventions such as local mental health training and joint service planning to promote network development we would expect to see over time an increase in the mean number of links, the frequency in which these links are used and the rated effectiveness of these links.
Northridge, Mary Evelyn; Freeman, Lance
Although the fields of urban planning and public health share a common origin in the efforts of reformers to tame the ravages of early industrialization in the 19th century, the 2 disciplines parted ways in the early 20th century as planners increasingly focused on the built environment while public health professionals narrowed in on biomedical causes of disease and disability. Among the unfortunate results of this divergence was a tendency to discount the public health implications of planning decisions. Given increasingly complex urban environments and grave health disparities in cities worldwide, urban planners and public health professionals have once again become convinced of the need for inclusive approaches to improve population health and achieve health equity. To make substantive progress, intersectoral collaboration utilizing ecological and systems science perspectives will be crucial as the solutions lie well beyond the control of any single authority. Grounded in the social determinants of health, and with a renewed sense of interconnectedness, dedicated and talented people in government agencies and communities who recognize that our future depends on cultivating local change and evaluating the results can come to grips with the enormous challenge that lies ahead to create more equitable, sustainable, and healthier cities worldwide.
Full Text Available 14.00 800x600 Normal 0 21 false false false ES-CO X-NONE X-NONE MicrosoftInternetExplorer4 What we know today as Health Services is a fiction, perhaps shaped involuntarily, but with deep health repercussions, more negative than positive. About 24 centuries ago, Asclepius god of medicine and Hygeia goddess of hygiene and health, generated a dichotomy between disease and health that remains until today. The confusing substitution of Health Services with Medical Services began by the end of the XIX century. But it was in 1948 when the so called English National Health Service became a landmark in the world and its model was adopted by many countries, having distorted the true meaning of Health Services. The consequences of this fiction have been ominous. It is necessary to call things by its name not to deceive society and to correct the serious imbalance between Medical Services and Health Services. Hygeia and Asclepius must become a brotherhood.
Quinn, Amity E; Reif, Sharon; Evans, Brooke; Creedon, Timothy B; Stewart, Maureen T; Garnick, Deborah W; Horgan, Constance M
Given the large numbers of providers and enrollees with which they interact, health plans can encourage the use of health information technology (IT) to advance behavioral health care. The manner and extent to which commercial health plans promote health IT to improve behavioral health care is unknown. This study aims to address that gap. Cross-sectional study. Data are from a nationally representative survey of commercial health plans regarding administrative and clinical dimensions of behavioral health services in 2010. Data are weighted to be representative of commercial managed care products in the United States (n = 8427; 88% response rate). Approaches within the domains of provider support, access to care, and assessment and treatment were investigated as examples of how health plans can promote health IT to improve behavioral health care delivery. Health plans were using health IT approaches in each domain. About a quarter of products offered financial support for electronic health records, but technical assistance was rare. Primary care providers could bill for e-mail contact with patients for behavioral health in about a quarter of products. Few products offered member-provider e-mail, and none offered online appointment scheduling. However, online referral systems and online provider directories were common, and nearly all offered an online self-assessment tool; most offered online counseling and online personalized responses to questions or problems. In 2010, commercial health plans encouraged the use of health IT strategies for behavioral health care. Health plans have an important role to play for increasing health IT as a tool for behavioral health care.
Coleman, J R; Kaminsky, F C; McGee, F
This paper describes "what if?" financial planning models developed for health care administrators and financial managers to study and evaluate the economic impact of changes in a health care organization's charge structure, operating policies, reimbursement plans, and services and resources. Models for inpatient and outpatient care systems are presented. The models are described in terms of input, output, and application. An assessment of the state of the art of financial planning and prospects for the future of what if?models are given.
Saunders, Carla; Carter, David J
Objective Delivering genuine integrated health care is one of three strategic directions in the New South Wales (NSW) Government State Health Plan: Towards 2021. This study investigated the current key health service plan of each NSW Local Health District (LHD) to evaluate the extent and nature of health systems integration strategies that are currently planned.Methods A scoping review was conducted to identify common key principles and practices for successful health systems integration to enable the development of an appraisal tool to content assess LHD strategic health service plans.Results The strategies that are planned for health systems integration across LHDs focus most often on improvements in coordination, health care access and care delivery for complex at-risk patients across the care continuum by both state- and commonwealth-funded systems, providers and agencies. The most common reasons given for integrated activities were to reduce avoidable hospitalisation, avoid inappropriate emergency department attendance and improve patient care.Conclusions Despite the importance of health systems integration and finding that all NSW LHDs have made some commitment towards integration in their current strategic health plans, this analysis suggests that health systems integration is in relatively early development across NSW.What is known about the topic? Effective approaches to managing complex chronic diseases have been found to involve health systems integration, which necessitates sound communication and connection between healthcare providers across community and hospital settings. Planning based on current health systems integration knowledge to ensure the efficient use of scarce resources is a responsibility of all health systems.What does this paper add? Appropriate planning and implementation of health systems integration is becoming an increasingly important expectation and requirement of effective health systems. The present study is the first of its
This report gives an update on the status of planning and delivery of mental health services for people with intellectual disability who have psychiatric disorders in Australia and New Zealand. A number of innovative approaches in policy and planning, legislative support, education, consultation, and coordination among services are discussed.…
As the demand for family planning services expands, governments and international donor agencies are finding it increasingly difficult to subsidize the costs of these services and are examining the feasibility of client fees. This issue of "The Family Planning Manager" evaluates the pros and cons of charging for services and outlines steps for instituting such a program. This process should be preceded by an assessment of the objective in introducing user fees, the ability and willingness of clients to pay for services, client perceptions of the quality of services, possible regulatory and political restrictions to charging fees, and the actual cost of each service provided. Registration, membership, service, and contraception fees are among the approaches to revenue generation. Fee determination can be based on ability to pay, fees charged for comparable services at benchmark clinics, in relation to the price of common household commodities (e.g., annual membership equivalent to the cost of 12 soft drinks), or specific cost recovery objectives (e.g., 25% of operating costs). The introduction of client fees requires a system for collecting and checking fees at service sites, exemption policies or waivers for those not able to afford the cost of services, internal financial controls, and regular financial reporting procedures. The community has a right to be informed about the fees that will be charged for each service, how the fees are being used, and whether the organization is making a profit. It is important to emphasize that revenue from fees will be used to enhance the quality of clinic services.
Hampel, Sally; Procter, Nicholas; Deuter, Kate
This paper reviews current literature on succession planning for mental health nurse practitioners (NPs) and discusses a model of succession planning that is underpinned by principals of leadership development, workforce participation and client engagement. The paper identifies succession planning as a means of managing a present and future workforce, while simultaneously addressing individual and organizational learning and practice development needs. A discussion of the processes attendant upon sustainable succession planning - collegial support, career planning and development, information exchange, capacity building, and mentoring is framed within the potential interrelationships between existing NP, developing NP and service directors and/or team managers. Done effectively and in partnership with wider clinical services, succession planning has the potential to build NP leadership development and leadership transition more broadly within mental health services.
Youkstetter, W D
Trends in health insurance are discussed, with emphasis on insurers' efforts to offer an array of cost-effective plans tailored to the needs of employers and subscribers. Health-insurance companies, responding to employers' demands to curtail the rising costs of premiums, now offer a variety of insurance products. While indemnity plans, health maintenance organizations (HMOs), and preferred-provider organizations (PPOs) remain as the three basic types of plans, insurers are combining these elements in different ways, creating dual- and triple-option plans that consist of indemnity insurance and an HMO, a PPO and an HMO, or other variations. Insurers offering multiple options may effect internal cost savings through shared personnel and administrative expenses. Four factors influence the development and marketing of insurance products: cost and volume of healthcare services, adverse selection, competition, and the profit incentive. Many of the insurance products have been developed in response to requests for maximum freedom of choice of provider; as an example, the fastest-growing HMO product in 1989 was the point-of-service HMO, which allows the subscriber to seek care from a provider who is not part of the HMO network. PPOs and exclusive-provider organizations (EPOs) are growing; these are often organized by hospitals or physician networks. Among the new trends in product-line development are "riders" for specialty services such as vision care and prescription drugs. As competition intensifies, marketing efforts are focusing on previously overlooked groups such as the small employer and certain ethnic communities. Cost and freedom of choice will remain important criteria in the selection of insurance products.(ABSTRACT TRUNCATED AT 250 WORDS)
Canesqui, A M
Even though the Brazilian government's position on birth control in the last few years has been ambiguous, it is moving away from the pro-life attitude that was prevalent in the 1960s and through the mid-1970s. The economic conditions during this period created a sense of urgency in establishing family planning programs to divert possible economic and social repercussions. The creation and expansion of family planning services in the last 2 decades have improved the distribution of contraceptives, related health care, and research. The problems of birth control and family planning are the same in Brazil as in the rest of the world. There is and always will be a moral, ethical, religious, or political question from the groups that traditionally oppose these concepts. The theme of responsible birth control is 1 of the tools used in the attempt to get the message across. Some results of irresponsible birth control are abortions, poverty, and misery. Proposals for integrating the various family planning services have not been implemented due to a lack of priorities in spending the available funds. Most of these health groups place responsibility for providing these methods of family planning upon the State. The groups say the State needs to consider women's freedom, sexuality and personal preferences in providing the family planning programs. A few groups prefer private sector sponsorship in order to preserve the woman's options concerning health care. The need for health care and the question of democracy both need to be taken into consideration when dealing with human reproduction. Attention should also be paid to the quality of health service, in order to guarantee less distortion of the issue and provide better medical care for all.
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Henderson, Marie; Page, Howard Philip
Often the hardest job is to get business representatives to look at security as something that makes managing their risks and achieving their objectives easier, with security compliance as just part of that journey. This paper addresses that by making planning for security services a 'business tool'.
Kash, Bita A; Deshmukh, A A
The purpose of this study was to develop a marketing plan for the Physical and Occupational Therapy (PT/OT) department at a Critical Access Hospital (CAH). We took the approach of understanding and analyzing the rural community and health care environment, problems faced by the PT/OT department, and developing a strategic marketing plan to resolve those problems. We used hospital admissions data, public and physician surveys, a SWOT analysis, and tools to evaluate alternative strategies. Lack of awareness and negative perception were key issues. Recommended strategies included building relationships with physicians, partnering with the school district, and enhancing the wellness program.
Li, Wenjing; Denson, Linley A.; Dorstyn, Diana S.
This study investigated help-seeking intentions and use of mental health services within a sample of 1128 Mainland Chinese college students (630 males and 498 females; mean age = 20.01 years, SD = 1.48). Results of structural equation modeling and logistic regression analysis suggested that social-cognitive variables had significant effects both…
Skitsou, Alexandra; Bekos, Christos; Charalambous, George
, ongoing education of health professionals along with relevant education of the community and the broad application of triage in the emergency departments will all contribute to delivering health services more effectively. Keywords: Cyprus, health services, patient rights...... and their families to be essential. Conclusions: The paper concludes that implementing guidelines in accordance with international best practices, the establishment of at-home treatment and nursing facilities, counseling the mentally ill in a way that promotes their social integration and occupational rehabilitation......Background: It has been observed that health services provided to certain patients in Cyprus do not fully meet their human rights. Objective: This study was conducted to identify the main shortcomings of the Health System in Cyprus. Methodology: The relevant administrative decisions...
Department of Health
The Healthcare Materials Management Board (HMMB) was established following the report to the Materials Management Advisory Group on procurement and materials management in the health sector Download the Report here
Anshari, Muhammad; Almunawar, Mohammad Nabil
Mobile technology enables health-care organizations to extend health-care services by providing a suitable environment to achieve mobile health (mHealth) goals, making some health-care services accessible anywhere and anytime. Introducing mHealth could change the business processes in delivering services to patients. mHealth could empower patients as it becomes necessary for them to become involved in the health-care processes related to them. This includes the ability for patients to manage their personal information and interact with health-care staff as well as among patients themselves. The study proposes a new position to supervise mHealth services: the online health educator (OHE). The OHE should be occupied by special health-care staffs who are trained in managing online services. A survey was conducted in Brunei and Indonesia to discover the roles of OHE in managing mHealth services, followed by a focus group discussion with participants who interacted with OHE in a real online health scenario. Data analysis showed that OHE could improve patients' confidence and satisfaction in health-care services.
Liersch, Judith M.
The manual is the first revision of the EES Program Planning Manual. At the states' request, there have been a number of changes to the state EES contacts list, and an updated list is included in this package as the revised Appendix D. Part I, Introduction, presents: How to Use the State Program Planning Manual and The Energy Extension Service Program. Part II, Applying for an EES Grant, presents: The Annual State Application for Financial Assistance; State Financial Assistance and Associated Requirements; Preparing the State Plan. Part III, Operating a State EES, presents: Start-Up Considerations; State Program Reporting; Recordkeeping and Financial Management. Part IV, DOE's Role, presents DOE Functions and Responsibilities and Special Cases: Development and Implementation of a State Plan by the EES Director and Administrative Review.
Elizabeth Andress: Partnerships Produce a National Center for Home Food Preservation. Diana Friedman: National 4-H Healthy Lifestyles Grant. H. Wallace Goddard: Big Surprises on the Road to Happiness. Nancy Kershaw: Connecting the 4-H Clothing Project and Community. Jane A. Landis: NEAFCS Living Well Public Service Campaign. Rhea Lanting: The Healthy Diabetes Plate. Phyllis B. Lewis: Product Look-Alikes. Anna Martin: Raising Diabetes Awareness in Latino Communities. Earl Mcalexander: Youth Fi...
Roemer, M I
Implementation of social insurance for financing health services has yielded different patterns depending on a country's economic level and its government's political ideology. By the late 19th century, thousands of small sickness funds operated in Europe, and in 1883 Germany's Chancellor Bismarck led the enactment of a law mandating enrollment by low-income workers. Other countries followed, with France completing Western European coverage in 1928. The Russian Revolution in 1917 led to a National Health Service covering everyone from general revenues by 1937. New Zealand legislated universal population coverage in 1939. After World War II, Scandinavian countries extended coverage to everyone and Britain introduced its National Health Service covering everyone with comprehensive care and financed by general revenues in 1948. Outside of Europe Japan adopted health insurance in 1922, covering everyone in 1946. Chile was the first developing country to enact statutory health insurance in 1924 for industrial workers, with extension to all low-income people with its "Servicio Nacional de Salud" in 1952. India covered 3.5 percent of its large population with the Employees' State Insurance Corporation in 1948, and China after its 1949 revolution developed four types of health insurance for designated groups of workers and dependents. Sub-Saharan African countries took limited health insurance actions in the late 1960s and 1970s. By 1980, some 85 countries had enacted social security programs to finance or deliver health services or both.
... Internal Revenue Service 26 CFR Part 54 RIN 1545-BJ58 Requirement for Group Health Plans and Health... Care Act (the Affordable Care Act) regarding preventive health services. The IRS is issuing the... Health and Human Services are issuing substantially similar interim final regulations with respect to...
Full Text Available The Chinese health system was once held up as a model for providing universal health care in the developing world in the 1970s, only to have what is now considered one of the least equitable systems in the world according to the World Health Organization. This article begins with a brief look at what equity in health services entails, and considers the inequities in access to health services in China among different segments of the population. This article will consider challenges the current inequities may present to China in the near future if reforms are not implemented. Finally, it will take a look at reforms made by China’s neighbors, Singapore and Thailand, which made their health care more equitable, affordable, and sustainable.
Telemedicine is a new adjunct to the delivery of health care services that has been applied to a range of health care specialties, including mental health. When prospective telemedicine programs are planned, telemedicine is often envisaged as simply a question of introducing new technology. The development of a robust, sustainable telemental health program involves clinical, technical, and managerial considerations. The major barriers to making this happen are usually how practitioners and patients adapt successfully to the technology and not in the physical installation of telecommunications bandwidth and the associated hardware necessary for teleconsultation. This article outlines the requirements for establishing a viable telemental health service, one that is based on clinical need, practitioner acceptance, technical reliability, and revenue generation. It concludes that the major challenge associated with the implementation of telemental health does not lie in having the idea or in taking the idea to the project stage needed for proof of concept. The major challenge to the widespread adoption of telemental health is paying sufficient attention to the myriad of details needed to integrate models of remote health care delivery into the wider health care system.
... Health Insurance Coverage Relating to Status as a Grandfathered Health Plan Under the Patient Protection...-AB68 Interim Final Rules for Group Health Plans and Health Insurance Coverage Relating to Status as a... Consumer Information and Insurance Oversight, Department of Health and Human Services. ACTION: Interim...
Sharon Reif, PhD
Full Text Available IntroductionThe US Public Health Service urges providers to screen patients for smoking and advise smokers to quit. Yet, these practices are not widely implemented in clinical practice. This study provides national estimates of systems-level strategies used by private health insurance plans to influence provider delivery of smoking cessation activities.MethodsData are from a nationally representative survey of health plans for benefit year 2003, across product types offered by insurers, including health maintenance organizations (HMOs, preferred provider organizations, and point-of-service products, regarding alcohol, tobacco, drug, and mental health services. Executive directors of 368 health plans responded to the administrative module (83% response rate. Medical directors of 347 of those health plans, representing 771 products, completed the clinical module in which health plan respondents were asked about screening for smoking, guideline distribution, and incentives for guideline adherence.ResultsOnly 9% of products require, and 12% verify, that primary care providers (PCPs screen for smoking. HMOs are more likely than other product types to require screening. Only 17% of products distribute smoking cessation guidelines to PCPs, and HMOs are more likely to do this. Feedback to PCPs was most frequently used to encourage guideline adherence; financial incentives were rarely used. Furthermore, health plans that did require screening often conducted other cessation activities.ConclusionFew private health plans have adopted techniques to encourage the use of smoking cessation activities by their providers. Increasing health plan involvement is necessary to reduce tobacco use and concomitant disease in the United States.
Radloff, D; Blouin, A S; Larsen, L; Kripp, M E
When planning for growth and management efficiency across urban health systems, economic and market factors present significant service line challenges and opportunities. This article describes the evolutionary integration of emergency services in St John Health System, a large, religious-sponsored health care system located in Detroit, Michigan. Critical business elements, including the System's vision, mission, and economic context, are defined as the framework for site-specific and System-wide planning. The impact of managed care and market changes prompted St John's clinicians and executives to explore how integrating emergency services could create a competitive market advantage.
Cox, William E,; Matthews, Frank L.
Interview with Dr. Louis Sullivan, Secretary of Health and Human Services. Discusses his views on health education, budget, access to health care, minority health, abortion, infant mortality, drugs, the Head Start Program, federal planning effects, and family influences. (JS)
Larisa Vulakh, Student Pharmacist
Full Text Available The objective of this study was to describe and compare prescription drug costs charged to a plan sponsor for the top 50 maintenance medications provided through retail and mail service procurement channels. Data were obtained for covered beneficiaries of a health plan sponsored by an employer with just over 3,000 covered employees The analytics team at the PBM administering the plan sponsor’s prescription drug benefit provided de-identified claims information for the top 50 maintenance prescription drugs delivered through either mail service or retail procurement methods for this employer over a one year period (7/1/2008 to 6/30/2009. Based on these data, (1 dollar amount difference (mail service minus retail, and (2 percentage difference between mail and retail costs (as a percentage of the lower net cost per day were computed. The findings revealed that 76 percent of the medication products studied were associated with a lower net cost per day to the plan sponsor through mail service procurement and 24 percent were associated with lower net cost through retail procurement.
... Revenue Service 26 CFR Part 54 RIN 1545-BJ57 Requirements for Group Health Plans and Health Insurance..., Health care, Health insurance, Pensions, Reporting and recordkeeping requirements. Proposed Amendments to... U.S. Department of Health and Human Services are issuing substantially similar interim final...
Full Text Available The service sector plays an increasingly large modern market economies. By being unable to provide customers a tangible product in the hands of service providers makes the situation more difficult. Their success depends on customer satisfaction, which expect a certain benefit for the money paid, on quality, on mutual trust and many other attributes. What is very interesting is that they may differ from client to client, and there is no guarantee satisfaction to all customers, even if the service provided is the same. This shows the complex nature of services and efforts on service providers would have to be made permanent in order to attract more customers. This paper addresses the issues of continuous quality improvement of health services as an important part of the services sector. Until recently, these services in Romania although under strict control of the state, had a large number of patients who are given very little attention, which is why quality improvement acestoraa was compulsory. Opening and changing economic environment, increasing customer demands, forced hospitals that serve as a nodal point between these services and their applicants to adopt modern management methods and techniques to become competitive and to give patients the quality service expected. Modern society has always sought to provide the means to ensure good health closer to the needs of modern man. These have become more complex and more expensive and naturally requires financial resources increasingly mari.Este why, every time, all the failures alleging lack of money and resources in general. Is it true? Sometimes yes, often, no! The truth is that human and material resources are not used in an optimal way. The answer lies mainly in quality management. We will see what should be done in this regard.
U.S. Department of Health & Human Services — A search-based Web service that provides access to disease, condition and wellness information via MedlinePlus health topic data in XML format. The service accepts...
Elsom, Stephen; Sands, Natisha; Roper, Cath; Hoppner, Cayte; Gerdtz, Marie
The participation of service users in all aspects of mental health service delivery including policy development, service planning and evaluation is increasingly an expectation of contemporary mental health care. Although there are a growing number of publications reporting service-user perspectives in the evaluation of mental health services, little attention has been paid to the views of service users about mental health triage services. The purpose of the study reported here was to examine service-users' (consumers and informal carers) experiences of a telephone-based mental health triage service. Using a framework developed from the World Health Organisation's elements of responsiveness, we conducted structured telephone interviews with service users who had contacted a telephone-based mental health triage service in regional Victoria, Australia. The main findings of the study were that consumers experienced more difficulty than carers in accessing the service and that, although most participants were satisfied, only a minority reported being involved in decision-making. Further work is needed to improve accessibility of mental health triage services and to investigate barriers to consumer self-referral. Professional development and practice support systems should be established to support mental health triage nurses in the development of collaborative, consumer-focused care.
U.S. Department of Health & Human Services — The dataset here provides the total number of Qualified Health Plan selections by ZIP Code for 37 states for the second Health Insurance Marketplace open enrollment...
Al-Sawai, Abdulaziz; Al-Shishtawy, Moeness M
In most countries, the lack of explicit health workforce planning has resulted in imbalances that threaten the capacity of healthcare systems to attain their objectives. This has directed attention towards the prospect of developing healthcare systems that are more responsive to the needs and expectations of the population by providing health planners with a systematic method to effectively manage human resources in this sector. This review analyses various approaches to health workforce planning and presents the Six-Step Methodology to Integrated Workforce Planning which highlights essential elements in workforce planning to ensure the quality of services. The purpose, scope and ownership of the approach is defined. Furthermore, developing an action plan for managing a health workforce is emphasised and a reviewing and monitoring process to guide corrective actions is suggested.
Full Text Available In most countries, the lack of explicit health workforce planning has resulted in imbalances that threaten the capacity of healthcare systems to attain their objectives. This has directed attention towards the prospect of developing healthcare systems that are more responsive to the needs and expectations of the population by providing health planners with a systematic method to effectively manage human resources in this sector. This review analyses various approaches to health workforce planning and presents the Six-Step Methodology to Integrated Workforce Planning which highlights essential elements in workforce planning to ensure the quality of services. The purpose, scope and ownership of the approach is defined. Furthermore, developing an action plan for managing a health workforce is emphasised and a reviewing and monitoring process to guide corrective actions is suggested.
Promotion of a health care provider's services is essential for communication with its customers and consumers. It is relevant to an organization's marketing strategy and is an element of what is described as the marketing mix. This paper considers the relationship of promotion to the marketing of services and proposes a plan for the promotion of the organization as a whole which can also be applied to an individual service or specialty. Whilst specific reference is made to an National Health Service (NHS) Trust it is also relevant to a Directly Managed Unit.
Sood, Neeraj; Wagner, Zachary; Huckfeldt, Peter; Haviland, Amelia
We use health insurance claims data from 63 large employers to estimate the extent of price shopping for nine common outpatient services in consumer-directed health plans (CDHPs) compared to traditional health plans. The main measures of price-shopping include: (1) the total price paid on the claim, (2) the share of claims from low and high cost providers and (3) the savings from price shopping relative to choosing prices randomly. All analyses control for individual and zip code level demographics and plan characteristics. We also estimate differences in price shopping within CDHPs depending on expected health care costs and whether the service was bought before or after reaching the deductible. For 8 out of 9 services analyzed, prices paid by CDHP and traditional plan enrollees did not differ significantly; CDHP enrollees paid 2.3% less for office visits. Similarly, office visits was the only service where CDHP enrollment resulted in a significantly larger share of claims from low cost providers and greater savings from price shopping relative to traditional plans. There was also no evidence that, within CDHP plans, consumers with lower expected medical expenses exhibited more price-shopping or that consumers exhibited more price-shopping before reaching the deductible.
Juan Eugenio Hernández-Ávila
Full Text Available Objetivo. Desarrollar un modelo automatizado de regionalización operativa para la planeación de las redes de servicios de salud propuestas en el Modelo Integrador de Atención a la Salud (MIDAS. Material y métodos. Con información disponible para México en 2005 y 2007 se realizó un modelo geoespacial para estimar el área potencial de influencia alrededor de cada unidad de atención médica, con base en el menor tiempo de viaje. Los resultados se compararon con un Estudio de Regionalización Operativa (ERO para Oaxaca llevado a cabo en 2005. Resultados. Comparado con el modelo geoespacial, el ERO asignó 48% de las localidades a centros de salud más lejanos y 23% de los centros de salud a hospitales más lejanos. Conclusiones. El modelo calculado en este estudio generó una regionalización más eficiente que el ERO de Oaxaca, minimizando el tiempo de viaje para el acceso a los servicios de salud. Este modelo ha sido adoptado por la Dirección General de Planeación y Desarrollo en Salud para la instrumentación del Plan Maestro Sectorial de Recursos para la Atención de la Salud.Objective. To develop an automated model for the operational regionalization needed in the planning of the health service networks proposed by the new Mexican health care model (Modelo Integrador de Servicios de Salud MIDAS. Material and Methods. Using available data for México during 2005 and 2007, a geospatial model was developed to estimate potential catchment areas around health facilities based on access travel time. The results were compared with an operational regionalization (ERO study manually carried out in Oaxaca with 2005 data. Results. The ERO assigned 48% of villages to health care centers further away than those assigned by the geospatial model, and 23% of these health centers referred patients to more distant hospitals. Conclusions. The model calculated by this study generated a more efficient regionalization than the ERO model, minimizing travel
BERNSTEIN, ROSE; HERZOG, ELIZABETH
FROM REPORTS AND DATA THAT WERE AVAILABLE TO THE UNITED STATES CHILDREN'S BUREAU THROUGH 1962, A REVIEW WAS MADE OF RESEARCH AND DEMONSTRATIONS THAT RELATED TO AVAILABILITY AND USE OF HEALTH SERVICES BY UNMARRIED MOTHERS. INCLUDED ARE COMPLICATIONS OF PREGNANCY IN BIRTHS OUT OF WEDLOCK--(1) STUDIES OF PRENATAL MEDICAL CARE FOR UNMARRIED MOTHERS,…
... HUMAN SERVICES Federal Health IT Strategic Plan: 2011-2015 Open Comment Period AGENCY: Office of the... the Federal Health IT Strategic Plan (developed June 3, 2008) in consultation with other appropriate... the Federal Health IT Strategic Plan is open through Friday, April 22 at 11:59 p.m. (Eastern)....
The author describes how the Understanding by Design (backwards planning) lesson plan format was used by his preservice K-12 students to develop service-learning lesson plans. Preservice teachers in a multicultural education course were given an assignment to develop service-learning lesson plans using the Understanding by Design planning process.…
West, R T; Howard, F H
A study to determine the impact that the Area Health Education Center type of programs may have on health science libraries was conducted by the Extramural Programs, National Library of Medicine, in conjunction with a contract awarded by the Bureau of Health Manpower, Health Resources Administration, to develop an inventory of the AHEC type of projects in the United States. Specific study tasks included a review of these programs as they relate to library and information activities, on-site surveys on the programs to define their needs for library services and information, and a categorization of library activities. A major finding was that health science libraries and information services are generally not included in AHEC program planning and development, although information and information exchange is a fundamental part of the AHEC type of programs. This study suggests that library inadequacies are basically the result of this planning failure and of a lack of financial resources; however, many other factors may be contributory. The design and value of library activities for these programs needs explication.
Berretta, Isabel Quint; Lacerda, Josimari Telino de; Calvo, Maria Cristina Marino
This article presents an evaluation model for municipal health planning management. The basis was a methodological study using the health planning theoretical framework to construct the evaluation matrix, in addition to an understanding of the organization and functioning designed by the Planning System of the Unified National Health System (PlanejaSUS) and definition of responsibilities for the municipal level under the Health Management Pact. The indicators and measures were validated using the consensus technique with specialists in planning and evaluation. The applicability was tested in 271 municipalities (counties) in the State of Santa Catarina, Brazil, based on population size. The proposed model features two evaluative dimensions which reflect the municipal health administrator's commitment to planning: the guarantee of resources and the internal and external relations needed for developing the activities. The data were analyzed using indicators, sub-dimensions, and dimensions. The study concludes that the model is feasible and appropriate for evaluating municipal performance in health planning management.
Hebert, Luciana Estelle; Schwandt, Hilary Megan; Boulay, Marc; Skinner, Joanna
In Nigeria, fertility continues to be high and contraceptive prevalence remains low. This study was conducted in order to understand the perceptions of, experiences with and challenges of delivering family planning services in two urban areas of Nigeria from the perspectives of family planning service providers. A qualitative study using 59 in-depth interviews was conducted among family planning providers working in hospitals, primary health centres, clinics, pharmacies and patent medicine vendors in Ibadan and Kaduna, Nigeria. Providers support a mix of individuals and organisations involved in family planning provision, including the government of Nigeria. The Nigerian government's role can take a variety of forms, including providing promotional materials for family planning facilities as well as facilitating training and educational opportunities for providers, since many providers lack basic training in family planning provision. Providers often describe their motivation to provide in terms of the health benefits offered by family planning methods. Few providers engage in any marketing of their services and many providers exclude youth and unmarried individuals from their services. The family planning provider community supports a diverse network of providers, but needs further training and support in order to improve the quality of care and market their services. Adolescents, unmarried individuals and women seeking post-abortion care are vulnerable populations that providers need to be better educated about and trained in how to serve. The perspectives of providers should be considered when designing family planning interventions in urban areas of Nigeria.
Curry, D.; Morgan, A.; Barbier, C.; Reay, P.
The required publication by distributed network operators (DNOs) of details of the current state of their network systems and future planned developments in the form of Long Term Development Statements (LTDS) are discussed. This project aims to increase the usefulness of the information in the LTDS by making it available on the internet and by providing an initial assessment of connection opportunities and the possibility of viewing existing renewable generation projects. The services developed covered data loading, data visualisation, security, connection assessment, reporting, and generation site registration. The benefits of an electronic version of the LTDS are highlighted.
Grover, Atul; Niecko-Najjum, Lidia M
Workforce planning in an era of health care reform is a challenge as both delivery systems and patient demographics change. Current workforce projections are based on a future health care system that is either an identified "ideal" or a modified version of the existing system. The desire to plan for such an "ideal system," however, may threaten access to necessary services if it does not come to fruition or is based on theoretical rather than empirical data.Historically, workforce planning that concentrated only on an "ideal system" has been centered on incorrect assumptions. Two examples of such failures presented in the 1980s when the Graduate Medical Education National Advisory Committee recommended a decrease in the physician workforce on the basis of predetermined "necessary and appropriate" services and in the 1990s, when planners expected managed care and health maintenance organizations to completely overhaul the existing health care system. Neither accounted for human behavior, demographic changes, and actual demand for health care services, leaving the nation ill-prepared to care for an aging population with chronic disease.In this article, the authors argue that workforce planning should begin with the current system and make adjustments based on empirical data that accurately reflect current trends. Actual health care use patterns will become evident as systemic changes are realized-or not-over time. No single approach will solve the looming physician shortage, but the danger of planning only for an ideal system is being unprepared for the actual needs of the population.
Brauner-Otto, Sarah R; Axinn, William G; Ghimire, Dirghaj J
We use detailed measures of social change over time, increased availability of various health services, and couples' fertility behaviors to document the independent effects of health services on fertility limitation. Our investigation focuses on a setting in rural Nepal that experienced a transition from virtually no use of birth control in 1945 to the widespread use of birth control by 1995 to limit fertility. Changes in the availability of many different dimensions of health services provide the means to evaluate their independent influences on contraceptive use to limit childbearing. Findings show that family planning as well as maternal and child health services have independent effects on the rate of ending childbearing. For example, the provision of child immunization services increases the rate of contraceptive use to limit fertility independently of family planning services. Additionally, new Geographic Information System (GIS)-based measures also allow us to test many alternative models of the spatial distribution of services. These tests reveal that complex, geographically defined measures of all health service providers outperform more simple measures. These results provide new information about the consequences of maternal and child health services and the importance of these services in shaping fertility transitions.
funding, and advances in automation, have dictated the need for information services to have a strong commitment to strategic planning . This paper...describes these trends and outlines the strategic planning process at the National Technical Information Service (NTIS). Initially resisted, strategic ... planning has become an important component of the agency management system. In recent years the planning system has been linked with performance plans of
Panthongviriyakul, Charnchai; Kessomboon, Pattapong; Sutra, Sumitr
Health problems and service utilization patterns among Thai populations have changed significantly over the past three decades. It is imperative to scrutinize the changes so that the health service and human resource development systems can appropriately respond to the changing health needs. To synthesize critical issues for future planning of health service reforms, medical education reforms and health research for Thai society. The authors analyzed data on health service utilization, types of illnesses and hospital deaths among Thais in the fiscal year 2010. Information on the illnesses of in-/out-patients and hospital deaths was extracted from the three main health insurance schemes providing coverage to 96% of the population. The authors then synthesized the key issues for reforming medical education and health services. In summary, Thai patients have better access to health services. The total number of out-patient visits was 326,230,155 times or 5.23 visits per population. The total number of in-patient admissions was 6,880,815 times or 0.11 admissions per population. The most frequent users were between 40-59 years of age. The most common conditions seen at OPD and IPD and the causes of in-hospital mortality varied between age-groups. The key health issues identified were: psychosocial conditions, health behaviour problems, perinatal complications, congenital malformations, teenage pregnancy, injury, infectious diseases, cardiovascular diseases and neoplasms. Medical education reforms need to be designed in terms of both undergraduate and post-graduate education and/or specialty clinical needs. Health service reforms should be designed in terms of patient care systems, roles of multidisciplinary teams and community involvement. The government and other responsible organizations need to actively respond by designing the health service systems and human resource development systems that are relevant, appropriate and integrated. Different levels of care need to
Bes, R.E.; Curfs, E.C.; Groenewegen, P.P.; Jong, J.D. de
In a health care system based on managed competition, health insurers negotiate on quality and price with care providers and are allowed to offer restrictive health plans. It is crucial that enrolees who need care choose restrictive health plans, as otherwise health insurers cannot channel patients
This document contains information about the Health and Safety Plan Guidelines. Topics discussed include: Regulatory framework; key personnel; hazard assessment; training requirements; personal protective equipment; extreme temperature disorders or conditions; medical surveillance; exposure monitoring/air sampling; site control; decontamination; emergency response/contingency plan; emergency action plan; confined space entry; and spill containment.
... 45 Public Welfare 1 2010-10-01 2010-10-01 false Special rules relating to group health plans. 146.145 Section 146.145 Public Welfare DEPARTMENT OF HEALTH AND HUMAN SERVICES REQUIREMENTS RELATING TO....145 Special rules relating to group health plans. (a) Group health plan—(1) Definition. A group...
Evidence-based data on staff development in mental health from low-middle ... mental health needsbased planning, primary healthcare, primary mental healthcare, mental ... It is feasible, with careful attention to planning and implementation of ...
Hagan, Brian J.; And Others
Warns that community mental health services are threatened by reductions in federal support and increased numbers of clients. Reviews literature on the effect of adverse economic events on mental health. Identifies issues and answers for managing this dilemma including planning, financial diversification, and inter-agency cooperation. (Author/JAC)
CDHPs can stabilize growth in health costs, but the health plan-subscriber relationship should be more transparent. CFOs should ensure that increased cost exposure in CDHPs is paired with broad, deep disease management and employee assistance support. Hospitals should plan for the likelihood that, one way or another, consumers will be paying more of their healthcare bill.
Er-sheng GAO; Jie YANG; Li-feng ZHOU; Mao-hua MIAO
Objective To make a theoretical exploration of the function of family-based health promotion in family planning development.Methods Given the notion of reproductive health and the function of family in society,the author bring forward a new mode of family planning service, that was "healthy,happy household promotion" based on the principle of health education and health promotion.Results The mode of "healthy, happy household promotion" reflected the new F.P.service mode, and was the direction of family planning service. It might benefit both service provider and clients to make the family as the entrance point of quality care of reproductive health in communities, to develop health education and health promotion,and promote family health and family happiness.Conclusion Family health and family happiness should be the final goal of family planning.
Dabiri, O M
Nigerians did not readily accept family planning when Family Health Services (FHS) began in 1988. FHS has made much headway in training, IEC (information, education, and communication), and constituency building and advocacy. Its staff have identified obstacles to implementation, especially program sustainability and management structure. Key limits to sustainability of IEC efforts were inadequately trained personnel and inability of trained personnel to apply what they learned at work stations. The Federal Ministry and Social Services' role in the FHS project was not clearly defined. Some private sector factors contributing to a confused management structure were inadequate method mix, high contraceptive cost, poor monitoring of quality of care, and no coordination of family planning training with the public factor. FHS has since decided to focus its efforts on increasing the demand for and availability of modern contraceptives and improving the quality of family planning services of both the public and private sectors. FHS hopes that accomplishing these activities will reduce fertility, morbidity, and mortality. Strategic plans include a regional focus, quality of care, a variety of methods offered, intensification, hospital and clinics, a management information system, contraceptive logistics, distribution regulations, and addressing social, cultural, and behavioral factors. To effectively implement the strategy, USAID and the Federal Ministry held a workshop in 1993 to effect full integration of Nigerian experience in the 2nd phase of the project (FHS II). Participants reviewed the strengths and weaknesses of the first phase and agreed on implementation. For example, nongovernmental organizations should implement FHS II. FHS II includes training, IEC, and commodities/logistics.
May 5, 1999 ... the technicians aimed at improving the services in health centres within ... Settings: Twenty seven health centres in Amhara region, north .... man power in the laboratory .... service consumption in a teaching hospital in Gondar,.
... SERVICES (CONTINUED) MEDICAL ASSISTANCE PROGRAMS SERVICES: GENERAL PROVISIONS Benchmark Benefit and Benchmark-Equivalent Coverage § 440.350 Employer-sponsored insurance health plans. (a) A State may provide benchmark or benchmark-equivalent coverage by obtaining employer sponsored health plans (either alone...
There has been, and still is a firm belief that regular use of dental services is beneficial for all. Thus governments in most European countries have shown some interest in training oral health care professionals, distributing the dental workforce and cost sharing. Constantly evolving treatment options and the introduction of new methods make dental clinicians feel uncertain as to which treatments are most useful, who would benefit from them, and which treatments will achieve cost-effective health gain. Although there is a considerable quantity of scientific literature showing that most available preventive measures are effective, and the number of sensible best-practice guidelines in prevention is growing, there are few studies on cost-efficiency of different methods and, secondly, the prevention and treatment guidelines are poorly known among general practitioners. In the eyes of the public, it is obvious that preventive methods practised by patients at home have been eclipsed by clinical procedures performed in dental clinics. Reliance on an increasingly individualistic approach to health care leads to the medicalisation of issues that are not originally health or medical problems. It is important to move general oral disease prevention back to the people who must integrate this in their daily routines. Prevention primarily based on healthy lifestyles, highlighted in the new public health strategy of the European Union (EU), is the key to future health policy.
... customer service from code-share partners; (11) Ensuring responsiveness to customer complaints; and (12... 14 Aeronautics and Space 4 2010-01-01 2010-01-01 false Customer service plan. 259.5 Section 259.5... REGULATIONS ENHANCED PROTECTIONS FOR AIRLINE PASSENGERS § 259.5 Customer service plan. (a) Adoption of...
Nichols, Don D.
This paper provides a synoptic review of student health services at the community college level while giving a more detailed description of the nature of health services at Orchard Ridge, a campus of Oakland Community College. The present College Health Service program provides for a part-time (24 hrs./wk.) nurse at Orchard Ridge. A variety of…
O'Hagan, Joshua; Persaud, David
Improving customer-service in health care organizations has been linked to better patient care, satisfied staff, a reduction in preventable medical errors, fewer malpractice lawsuits and improved revenue. However, it has been observed that there is sometimes a gap between the level of customer-service provided by health care organizations and their clients' expectations. This paper integrates, synthesizes and extends theory and practice from existing literature to provide health care organizations with strategies for closing this gap. Methods are also outlined for creating, implementing and evaluating an organizational plan for improving customer-service.
US Fish and Wildlife Service, Department of the Interior — This is the Hunting Plan for Sherburne NWR. The Plan provides an introduction to the Refuge, information about conformance with statutory authorities, a statement of...
Weintraub, D R; Wald, S B
Recently it has been asserted that family planning should be offered primarily through maternal and child health (MCH) programs. Others have argued that family planning should be provided only in a comprehensive medical services setting. A pilot study was made during 1968 and 1969 of 12 family planning clinics in New York City with the finding that clinics with a specialized family planning staff provided the same or better quality service and saw significantly more women. In 1971, the National Center for Family Planning Services sponsored a national county-by-county study to obtain information for assessing progress toward providing subsidized family planning services to all persons in need. Results showed that as of 1971, 60% of the 1.9 million patients who received family planning services received them in specialized clinics. Even in hospitals, more than 3 in 10 family planning patients received care in specialized clinics. The conclusion reached is that whatever the advantages of combined or specialized services, neither the MCH system nor general medical care facilities could integrate the current specialized family planning caseload without massive reorganization of the health delivery system and its financing.
Kalita, Anuska; Zaidi, Sarover; Prasad, Vandana; Raman, V R
The Public Health Resource Network is an innovative distance-learning course in training, motivating, empowering and building a network of health personnel from government and civil society groups. Its aim is to build human resource capacity for strengthening decentralized health planning, especially at the district level, to improve accountability of health systems, elicit community participation for health, ensure equitable and accessible health facilities and to bring about convergence in programmes and services. The question confronting health systems in India is how best to reform, revitalize and resource primary health systems to deliver different levels of service aligned to local realities, ensuring universal coverage, equitable access, efficiency and effectiveness, through an empowered cadre of health personnel. To achieve these outcomes it is essential that health planning be decentralized. Districts vary widely according to the specific needs of their population, and even more so in terms of existing interventions and available resources. Strategies, therefore, have to be district-specific, not only because health needs vary, but also because people's perceptions and capacities to intervene and implement programmes vary. In centrally designed plans there is little scope for such adaptation and contextualization, and hence decentralized planning becomes crucial. To undertake these initiatives, there is a strong need for trained, motivated, empowered and networked health personnel. It is precisely at this level that a lack of technical knowledge and skills and the absence of a supportive network or adequate educational opportunities impede personnel from making improvements. The absence of in-service training and of training curricula that reflect field realities also adds to this, discouraging health workers from pursuing effective strategies. The Public Health Resource Network is thus an attempt to reach out to motivated though often isolated health
Full Text Available Abstract The Public Health Resource Network is an innovative distance-learning course in training, motivating, empowering and building a network of health personnel from government and civil society groups. Its aim is to build human resource capacity for strengthening decentralized health planning, especially at the district level, to improve accountability of health systems, elicit community participation for health, ensure equitable and accessible health facilities and to bring about convergence in programmes and services. The question confronting health systems in India is how best to reform, revitalize and resource primary health systems to deliver different levels of service aligned to local realities, ensuring universal coverage, equitable access, efficiency and effectiveness, through an empowered cadre of health personnel. To achieve these outcomes it is essential that health planning be decentralized. Districts vary widely according to the specific needs of their population, and even more so in terms of existing interventions and available resources. Strategies, therefore, have to be district-specific, not only because health needs vary, but also because people's perceptions and capacities to intervene and implement programmes vary. In centrally designed plans there is little scope for such adaptation and contextualization, and hence decentralized planning becomes crucial. To undertake these initiatives, there is a strong need for trained, motivated, empowered and networked health personnel. It is precisely at this level that a lack of technical knowledge and skills and the absence of a supportive network or adequate educational opportunities impede personnel from making improvements. The absence of in-service training and of training curricula that reflect field realities also adds to this, discouraging health workers from pursuing effective strategies. The Public Health Resource Network is thus an attempt to reach out to motivated
唐松源; 杨瑶; 武慧欣; 崔文龙
[Objective] To describe and compare the cost of family planning services in 2 different counties, and to examine the proportion of the major component in the total cost of family planning service. [Methods] The literature review, existing data review and in-depth interview were used to collect the data in 2 counties. [Results] (1) Government investment occupied the majority of the total cost (2) Personnel cost, utility cost and depreciation of fixed assets were the major parts of the total cost [Conclusion] We should improve the utilization of family planning resources to increase the quality of reproductive health services.%[目的]通过调查东西部两个项目县的县级计划生育服务机构的各项成本,了解各类成本与总成本的关系,为计划生育服务机构的发展提供借鉴.[方法]收集市、县两级计划生育机构有关计划生育服务的成本数据,并运用文献回顾、现有资料收集及个人深入访谈等方法了解机构的相关情况.[结果](1)国家投入占绝大部分;(2)人员经费、办公费和固定资产折旧为总成本中比例最高的3个方面.[结论]应提高对计划生育机构相关资源的有效利用,从而为计划生育工作的长期、稳定发展提供借鉴.
Jan 18, 2011 ... health services, nursing services, and health education. Other areas ... (2001) sees school health services to be those services that take care of the health needs ..... Network, Family Health International 14:2:30. Chisango, T.
Brittain, Anna W; Williams, Jessica R; Zapata, Lauren B; Moskosky, Susan B; Weik, Tasmeen S
Family planning services are essential for reducing high rates of unintended pregnancies among young people, yet a perception that providers will not preserve confidentiality may deter youth from accessing these services. This systematic review, conducted in 2011, summarizes the evidence on the effect of assuring confidentiality in family planning services to young people on reproductive health outcomes. The review was used to inform national recommendations on providing quality family planning services. Multiple databases were searched to identify articles addressing confidentiality in family planning services to youth aged 10-24 years. Included studies were published from January 1985 through February 2011. Studies conducted outside the U.S., Canada, Europe, Australia, or New Zealand, and those that focused exclusively on HIV or sexually transmitted diseases, were excluded. The search strategy identified 19,332 articles, nine of which met the inclusion criteria. Four studies examined outcomes. Examined outcomes included use of clinical services and intention to use services. Of the four outcome studies, three found a positive association between assurance of confidentiality and at least one outcome of interest. Five studies provided information on youth perspectives and underscored the idea that young people greatly value confidentiality when receiving family planning services. This review demonstrates that there is limited research examining whether confidentiality in family planning services to young people affects reproductive health outcomes. A robust research agenda is needed, given the importance young people place on confidentiality. Published by Elsevier Inc.
Begun, James W; Kaissi, Amer
The definition and scope of health services administration are important to public policy, educational programs, new entrants to the field, and practitioners. Formal definition of the field of health services administration has not received concerted attention since 1975. Significant changes in the field have occurred since that time, widening opportunities for graduates of educational programs and increasing interdependencies between health services organizations and public policy organizations, supplier organizations, insurers, and other businesses that are not involved directly in health services delivery. Stakeholders in the field of health services administration should consider a broadened definition of the field that would institutionalize and build on those increased opportunities and interdependencies.
US Fish and Wildlife Service, Department of the Interior — The Merritt Island NWR Visitor Services Plan outlines long term and short term goals for six wildlife dependent public use activities and programs that are...
Purpose. Guided by the World Health Organization\\'s International Classification of Functioning, Disability and Health (ICF), a measure of activity and participation (MAP) was developed and incorporated into the National Physical and Sensory Disability Database in Ireland. The aims of this article are to investigate and explore the relationship between the barriers, participation restriction and functioning levels experienced by people with disabilities. Method. Seven thousand five hundred and sixty-two personal interviews with people meeting specific eligibility criteria for registering onto the database were conducted across four health service executive regions in Ireland. Results. Overall, differences in barriers, participation restriction and activity limitations experienced by people with different types of disabilities were found to be significant. Furthermore, low functioning and experience of barriers were indicators of participation restriction. Conclusions. This article has shown that elements of the ICF have been successfully operationalised in a service planning tool through the development of the MAP. This provides a more holistic view of disability and will enable the impact of service interventions to be measured over time.
Higgins, A; Maguire, G; Watts, M; Creaner, M; McCann, E; Rani, S; Alexander, J
In recent years, there is an ever increasing call to involve people who use mental health services in the development, delivery and evaluation of education programmes. Within Ireland, there is very little evidence of the degree of service user involvement in the educational preparation of mental health practitioners. This paper presents the findings on service user involvement in the education and training of professionals working in mental health services in Ireland. Findings from this study indicate that in the vast majority of courses curricula are planned and delivered without consultation or input from service users. Currently the scope of service user involvement is on teaching, with little involvement in curriculum development, student assessment and student selection. However, there is evidence that this is changing, with many respondents indicating an eagerness to move this agenda forward.
In today’s competitive environment, medical practices cannot do without advertising their services in order to attract and retain patients. Marketing in health care has become as essential as within any other industry. Therefore, this product-oriented thesis aims at creating an integrated marketing communications plan for the case company, Orthopaedic Health Centre Rhein-Neckar. The company’s objective is to increase sales generated by its diagnostic methods and treatment options for arthrosi...
Mahendra, A; Vo, T; Einstoss, C; Weppler, J; Gillen, P; Ryan, L; Haley, K
Land use planning is a complex field comprised of legislation, policies, processes and tools. A growing body of evidence supports the relationship between land use planning decisions, community design and health. The built environment has been shown to be associated with physical inactivity, obesity, cardiovascular disease, respiratory disease and mental illness. Consequently, there is a growing interest within public health to work with planners on land use planning initiatives such as official plans and transportation master plans. Two surveys were developed: one for public health professionals and the other for planning professionals (survey questions available upon request to the corresponding author). The surveys were pilot tested in two separate focus group sessions with public health and planning professionals. Focus group volunteers helped to validate the surveys by verifying survey questions, design and overall flow. In early 2012, 304 public health professionals and 301 planning professionals completed the two separate surveys, comprising the total survey respondents for each respective profession used to calculate proportions. The survey results represent a convenience sample and are not generalizable to the entire population of public health and planning professionals in Ontario. Results compare survey responses from both groups where appropriate. Most respondents worked either as public health staff (78%) or planners/senior planners (58%). A smaller percentage of public health and planning professionals worked either as managers (15% and 11%, respectively) or directors (5% and 9%, respectively). Health is associated with how communities are planned and built, and the services and resources provided within them. Inspired by the results of our survey and based on user feedback from the pilot tests, a free online training program entitled "Public Health and Planning 101: An Online Course for Public Health and Planning Professionals to Create Healthier
Andersen, John Sahl; Olivarius, Niels de Fine; Krasnik, Allan
Abstract Introduction: To describe the Danish National Health Service Register in relation to research. Content: The register contains data collected for administrative and scientific purposes from health contractors in primary health care. It includes information about citizens, providers...
Bradley, H; Bedada, A; Tsui, A; Brahmbhatt, H; Gillespie, D; Kidanu, A
Integrating voluntary HIV counselling and testing (VCT) with family planning and other reproductive health services may be one effective strategy for expanding VCT service delivery in resource poor settings. Using 30,257 VCT client records with linked facility characteristics from Ethiopian non-governmental, non-profit, reproductive health clinics, we constructed multi-level logistic regression models to examine associations between HIV and family planning service integration modality and three outcomes: VCT client composition, client-initiated HIV testing and client HIV status. Associations between facility HIV and family planning integration level and the likelihood of VCT clients being atypical family planning client-types, versus older (at least 25 years old), ever-married women were assessed. Relative to facilities co-locating services in the same compound, those offering family planning and HIV services in the same rooms were 2-13 times more likely to serve atypical family planning client-types than older, ever-married women. Facilities where counsellors jointly offered HIV and family planning services and served many repeat family planning clients were significantly less likely to serve single clients relative to older, married women. Younger, single men and older, married women were most likely to self-initiate HIV testing (78.2 and 80.6% respectively), while the highest HIV prevalence was seen among older, married men and women (20.5 and 34.2% respectively). Compared with facilities offering co-located services, those integrating services at room- and counsellor-levels were 1.9-7.2 times more likely to serve clients initiating HIV testing. These health facilities attract both standard material and child health (MCH) clients, who are at high risk for HIV in these data, and young, single people to VCT. This analysis suggests that client types may be differentially attracted to these facilities depending on service integration modality and other facility
Ellen D. Hoadley
Full Text Available Turbulent market conditions have forced the health care sector to re-examine its business and operational practices. Health care has become increasingly complex as decisions and planning are reframed in light of the current lagging economy, an increased demand for services, new global competition, and impending legislation reform. The stress is felt most keenly within the nation’s hospitals and consortia of health care facilities. Facility planning decisions are no exception. Hospital administrators are abandoning the once commonplace rules governing aging infrastructure renovations. Instead, administrators are basing decisions within their respective strategic context and are attempting to align buildings, services, personnel, and technology to an overall plan that looks at markets, operations, and finances as resources for competitive advantage. This paper reviews the strategic facilities planning literature and applies those best practices which support this organizational alignment for health care. An application in the mid-Atlantic demonstrates that hospital facilities, by design, need to support the current and future needs of health care delivery systems, while dated structures impede industry advances. Health care infrastructure improvements must proactively address technological, regulatory, and financial changes facing the sector.
Dixon, Decia Nicole
Latest research on the mental health status of children indicates that schools are key providers of mental health services (U.S. Department of Health and Human Services, 2003). The push for school mental health services has only increased as stakeholders have begun to recognize the significance of sound mental health as an essential part of…
McCarty, Maureen V; Fenech, Bethany J
Health Workforce Australia (HWA) was established by the Council of Australian Governments through its 2008 National Partnership Agreement on Hospital and Health Workforce Reform, as the national agency to progress health workforce reform and address the challenges of providing a skilled, innovative and flexible health workforce in Australia. The Australian Health Ministers' Conference commissioned HWA to undertake a workforce planning exercise for doctors, nurses and midwives over a planning horizon to 2025. Health Workforce 2025 (HW 2025) was conducted in two phases: developing projections for the size and type of the health workforce (doctors, nurses and midwives) needed to meet future service requirements from 2012 to 2025; and modelling the training pipeline necessary to meet the size and type of this health workforce. HWA has used a number of key principles in developing HW 2025 to ensure the projections are robust and able to be applied nationally. HW 2025 is not a one-off project. Projections will be updated as new data become available, and methodology and assumptions underpinning the projections will be periodically reviewed. To also ensure the continued improvement of national health workforce planning, HWA is pursuing other areas for improvement, including better national data collections and improved estimation methodology for demand. Results of HW 2025 were presented to the Australian Health Ministers (through the Standing Council on Health) in April 2012.
Whitaker, Linda A.
In view of women's misconceptions about their bodies, their sexuality, their mental health, and the health care system, this three-credit evening community college course on women's health needs and concerns was designed. Course objectives include recording and analyzing the effects of nutrition, sleep, exercise, and stress on various body…
... also may need to do some paperwork for tax purposes. How to Compare Health Plans Employers and ... urac.org). URAC's accreditation program is an independent audit to verify that A.D.A.M. follows ...
Full Text Available With the objective of choosing a practical and valid method to delimit health service areas of regional health service centres to build a regional basic health service network, we first drew lessons from traditional geographic methods of delimiting trade areas and then applied two methods to delimit health service areas, i.e. the proximal method and the gravity method. We verified the effectiveness of these methods by an index of similarity with the aid of real in-patient data. Calculation of the similarity indices shows that health service areas delimited by the proximal method has an 87.3% similarity to the real health service area, while the gravity method gives 88.6%. Our conclusion is that both methods are suitable for delimiting health service areas at regional health service centres, but find that the proximal method is more practicable in operational terms for delimiting health service areas in region health planning.
The philosophic basis and proposed implementation of an energy outreach program were set forth in a proposal of December 5, 1975 and in a revised proposal and budget of March 22, 1976, submitted after consultation with ERDA officials. The objectives and scope of work for the initial ten-month period presently contracted, and for the balance of the proposed two-year program, are summarized in the ERDA document ''Project: Outreach Program for Energy Information Dissemination in Adjacent Areas of New York, New Jersey, and Connecticut''. A copy is included at the end of this report. The implementation plan set forth here specifies the nature and the time schedule of the work to be accomplished throughout the tem-month and the two-year periods. In order to disseminate information to target audiences, the institute will utilize various energy technology channels of communications, including, the Energy Information Center; NYIT Energy Hot Line; Metropolitan Regional Council Television Seminars; Referral Services; press releases; technical assisance teams; newspaper question-and-answer columns; traveling displays; contests; conferences; radio spots; volunteers; and Center for Energy Policy and Research Periodical. All energy topics are included, but priority in the short term will be given to energy management programs for small commercial/industrial plants; residential building insulation and weatherization; solar hot water heating and solar space heating systems; and heat pumps. (MCW)
Lazovik, Alexander; Aiello, Marco; Papazoglou, Mike
Interaction with web services enabled marketplaces would be greatly facilitated if users were given a high level service request language to express their goals in complex business domains. This can be achieved by using a planning framework which monitors the execution of planned goals against prede
... juvenile and adult correctional facilities. (c) In developing the plan, the Secretary of the Interior must... 34 Education 2 2010-07-01 2010-07-01 false Plan for coordination of services. 300.713 Section 300... EDUCATION AND REHABILITATIVE SERVICES, DEPARTMENT OF EDUCATION ASSISTANCE TO STATES FOR THE EDUCATION...
The demand for knowledge of productive health and the current status of productive health services provided by relevant governmental institutions were qualitatively and quantitatively studied. The study identified the key factors that influenced the demand for the productive health services and results of the services. It also discussed the effective approaches to control, planning and sustainable development of the reproductive health services for the floating populations.
... NewsYour Health ResourcesHealthcare Management End-of-Life Issues Insurance & Bills Self Care Working With Your Doctor Drugs, ... NewsYour Health ResourcesHealthcare Management End-of-Life Issues Insurance & Bills Self Care Working With Your Doctor Drugs, ...
Panini, Roberta; Fiorini, Fulvio
In the last twenty years, the hospitals have become firms, therefore they have had the necessity to differentiate from each other.Thus, as it is done in the commercial firms, in the health service different formality of communication are studied and introduced in order to attract new consumers and to maintain their trust. Furthermore, due to the introduction of the digitization in the Public Administrations, the communication has become more transparent.A systematic application of communication tools is more and more spread among the Sanitary Firms, whether they are Local Firm or Hospital Firm.Regarding the reference population, communication tools are used with different purposes such as educational and informative. In addition, they are applied as institutional marketing tool, in order to show the offered potentialities and also to increase the level of satisfaction in the patients/consumers who perceive the typology of reception and treatment during the sanitary performance.
Erstad, Brian L; Mann, Henry J; Weber, Robert J
Critical care medicine has grown from a small group of physicians participating in patient care rounds in surgical and medical intensive care units (ICUs) to a highly technical, interdisciplinary team. Pharmacy's growth in the area of critical care is as exponential. Today's ICU requires a comprehensive pharmaceutical service that includes both operational and clinical services to meet patient medication needs. This article provides the elements for a business plan to justify critical care pharmacy services by describing the pertinent background and benefit of ICU pharmacy services, detailing a current assessment of ICU pharmacy services, listing the essential ICU pharmacy services, describing service metrics, and delineating an appropriate timeline for implementing an ICU pharmacy service. The structure and approach of this business plan can be applied to a variety of pharmacy services. By following the format and information listed in this article, the pharmacy director can move closer to developing patient-centered pharmacy services for ICU patients.
Adlung, R.; Carzaniga, A.
The potential for trade in health services has expanded rapidly in recent decades. More efficient communication systems have helped to reduce distance-related barriers to trade; rising incomes and enhanced information have increased the mobility of patients; and internal cost pressures have led various governments to consider possibilities for increased private participation. As yet, however, health services have played only a modest role in the General Agreement on Trade in Services (GATS). ...
Guerrero, Erick G; Andrews, Christina; Harris, Lesley; Padwa, Howard; Kong, Yinfei; M S W, Karissa Fenwick
In this mixed-method study, we examined coordination of mental health and public health services in addiction health services (AHS) in low-income racial and ethnic minority communities in 2011 and 2013. Data from surveys and semistructured interviews were used to evaluate the extent to which environmental and organizational characteristics influenced the likelihood of high coordination with mental health and public health providers among outpatient AHS programs. Coordination was defined and measured as the frequency of interorganizational contact among AHS programs and mental health and public health providers. The analytic sample consisted of 112 programs at time 1 (T1) and 122 programs at time 2 (T2), with 61 programs included in both periods of data collection. Forty-three percent of AHS programs reported high frequency of coordination with mental health providers at T1 compared to 66% at T2. Thirty-one percent of programs reported high frequency of coordination with public health services at T1 compared with 54% at T2. Programs with culturally responsive resources and community linkages were more likely to report high coordination with both services. Qualitative analysis highlighted the role of leadership in leveraging funding and developing creative solutions to deliver coordinated care. Overall, our findings suggest that AHS program funding, leadership, and cultural competence may be important drivers of program capacity to improve coordination with health service providers to serve minorities in an era of health care reform.
Rousseau, Cécile; Nadeau, Lucie; Pontbriand, Annie; Johnson-Lafleur, Janique; Measham, Toby; Broadhurst, Joanna
The importance of children and youth mental health is increasingly recognized. This rapidly developing field cannot be conceptualized as an extension of adult services to a younger age group and its developmental and organizational specificities are the object of debate. Reviewing recent literature in this domain and some preliminary information about the Quebec Mental Health Plan implementation, this paper addresses some of the questions which structure this debate in Quebec.Quebec mental health plan has put at the forefront collaboration among disciplines and partnership among institutions. In spite of having produced significant improvement in the field, discontinuities in services, which interfere with an ecosystemic model of care, persist. Recent studies suggest that the organisational climate which surrounds youth mental health services has a direct impact on the quality of services and on youth health outcomes. A flexible management structure, which engages clinicians and health workers, favors empowerment, minimizes work stress and facilitates partnership, is needed to foster successful interdisciplinary and intersectorial collaboration. This collaboration is the cornerstone of youth mental health services.
... RESEARCH MISCONDUCT Definitions § 93.220 Public Health Service or PHS. Public Health Service or PHS means... 42 Public Health 1 2010-10-01 2010-10-01 false Public Health Service or PHS. 93.220 Section 93.220 Public Health PUBLIC HEALTH SERVICE, DEPARTMENT OF HEALTH AND HUMAN SERVICES HEALTH ASSESSMENTS...
The basic health and safety requirements established in this plan are designed to provide guidelines to be applied at all Uranium Mill Tailings Remedial Action (UMTRA) Project sites. Specific restrictions are given where necessary. However, an attempt has been made to provide guidelines which are generic in nature, and will allow for evaluation of site-specific conditions. Health and safety personnel are expected to exercise professional judgment when interpreting these guidelines to ensure the health and safety of project personnel and the general population. This UMTRA Project Environmental, Health, and Safety (EH S) Plan specifies the basic Federal health and safety standards and special DOE requirements applicable to this program. In addition, responsibilities in carrying out this plan are delineated. Some guidance on program requirements and radiation control and monitoring is also included. An Environmental, Health, and Safety Plan shall be developed as part of the remedial action plan for each mill site and associated disposal site. Special conditions at the site which may present potential health hazards will be described, and special areas that should should be addressed by the Remedial Action Contractor (RAC) will be indicated. Site-specific EH S concerns will be addressed by special contract conditions in RAC subcontracts. 2 tabs.
McFadyen, J A; Farrington, A
AIM AND KEY ISSUES: This article reviews the theoretical basis of strategic management in an attempt to provide managers with a better understanding of the underpinning concepts and consequent actions they need to take to avoid loss of control and ultimate failure. The authors argue that community care for the severely mentally ill is failing and that in part the reason for this perceived failure is a closer allegiance to primary care that has shifted the focus away from mental illness. Such a shift, coupled with poor management and a desire by Community Mental Health Nurses (CMHNs) to retain a broad focus and maintain the 'autonomy' they gain when not held in the gravitational grasp of Consultant Psychiatrists, has resulted in strategic drift. The authors suggest 10 possible reasons to explain why CMHNs currently fail to meet the needs of the severely mentally ill. Among these are a lack of explicit strategic implementation plans, professional ambivalence and self-interest, poor management of resources and conflicting demands from key interest groups. It seems that mental health services in this country have reached the point where resistance to change should be crumbling in the face of perceived failure to deliver the required services. Whilst it could be argued that a major and potent source of internal change is performance gaps, few things force change more than sudden and unexpected information about poor organizational performance.
Full Text Available Abstract Background Both availability and quality of family planning services are believed to have contributed to increasing contraceptive use and declining fertility rates in developing countries. Yet, there is limited empirical evidence to show the relationship between the quality of family planning services and the population based prevalence of contraceptive methods. This study examined the relationship between quality of family planning services and use of intrauterine devices (IUD in Egypt. Methods The analysis used data from the 2003 Egypt Interim Demographic and Health Survey (EIDHS that included 8,445 married women aged 15–49, and the 2002 Egypt Service Provision Assessment (ESPA survey that included 602 facilities offering family planning services. The EIDHS collected latitude and longitude coordinates of all sampled clusters, and the ESPA collected these coordinates for all sampled facilities. Using Geographic Information System (GIS methods, individual women were linked to a facility located within 10 km of their community. A facility-level index was constructed to reflect the quality of family planning services. Four dimensions of quality of care were examined: counseling, examination room, supply of contraceptive methods, and management. Effects of quality of family planning services on the use of IUD and other contraceptive methods were estimated using multinomial logistic regression. Results are presented as relative risk ratios (RRR with significance levels (p-values. Results IUD use among women who obtained their method from public sources was significantly positively associated with quality of family planning services (RRR = 1.36, p Conclusion This study is one among the few that used geographic information to link data from a population-based survey with an independently sampled health facility survey. The findings demonstrate that service quality is an important determinant of use of clinical contraceptive methods in Egypt
Levine, M A
Professional skills developed in providing maternal and child care in the industrialised world can be applied to the provision of appropriate services to emerging nations. Understanding local mores and values, one can more effectively convey the essential elements of maintenance and promotion of health. By volunteering to work with a locally based relief organisation in Arequipa, Peru, I helped to facilitate cross-cultural planned health change in the maternal/child health programme.
Full Text Available Mary-Louise Jung1, Karla Loria11Division of Industrial Marketing, e-Commerce and Logistics, Lulea University of Technology, SwedenObjective: To investigate older people’s acceptance of e-health services, in order to identify determinants of, and barriers to, their intention to use e-health.Method: Based on one of the best-established models of technology acceptance, Technology Acceptance Model (TAM, in-depth exploratory interviews with twelve individuals over 45 years of age and of varying backgrounds are conducted.Results: This investigation could find support for the importance of usefulness and perceived ease of use of the e-health service offered as the main determinants of people’s intention to use the service. Additional factors critical to the acceptance of e-health are identified, such as the importance of the compatibility of the services with citizens’ needs and trust in the service provider. Most interviewees expressed positive attitudes towards using e-health and find these services useful, convenient, and easy to use.Conclusion: E-health services are perceived as a good complement to traditional health care service delivery, even among older people. These people, however, need to become aware of the e-health alternatives that are offered to them and the benefits they provide.Keywords: health services, elderly, technology, Internet, TAM, patient acceptance, health-seeking behavior
Lindsay, Patrice; Furie, Karen L; Davis, Stephen M; Donnan, Geoffrey A; Norrving, Bo
Every two seconds, someone across the globe suffers a symptomatic stroke. 'Silent' cerebrovascular disease insidiously contributes to worldwide disability by causing cognitive impairment in the elderly. The risk of cerebrovascular disease is disproportionately higher in low to middle income countries where there may be barriers to stroke care. The last two decades have seen a major transformation in the stroke field with the emergence of evidence-based approaches to stroke prevention, acute stroke management, and stroke recovery. The current challenge lies in implementing these interventions, particularly in regions with high incidences of stroke and limited healthcare resources. The Global Stroke Services Action Plan was conceived as a tool to identifying key elements in stroke care across a continuum of health models. At the minimal level of resource availability, stroke care delivery is based at a local clinic staffed predominantly by non-physicians. In this environment, laboratory tests and diagnostic studies are scarce, and much of the emphasis is placed on bedside clinical skills, teaching, and prevention. The essential services level offers access to a CT scan, physicians, and the potential for acute thrombolytic therapy, however stroke expertise may still be difficult to access. At the advanced stroke services level, multidisciplinary stroke expertise, multimodal imaging, and comprehensive therapies are available. A national plan for stroke care should incorporate local and regional strengths and build upon them. This clinical practice guideline is a synopsis of the core recommendations and quality indicators adapted from ten high quality multinational stroke guidelines. It can be used to establish the current level of stroke services, target goals for expanding stroke resources, and ensuring that all stages of stroke care are being adequately addressed, even at the advanced stroke services level. This document is a start, but there is more to be done
In this article, the different dimensions and determinants of health workforce planning (HWF) are investigated to improve context-sensitivity and mutual learning among groups of countries with similar HWF characteristics. A novel approach to scoring countries according to their HFW characteristics and type of planning is introduced using data collected in 2012 by a large European Union project involving 35 European countries (the 'Matrix Study' ). HWF planning is measured in terms of three major dimensions: (1) data infrastructure to monitor the capacities and dynamics of health workforces, (2) the institutions involved in defining and implementing labour market regulations, and (3) the availability of models to estimate supply-demand gaps and to forecast imbalances. The result shows that the three dimensions of HWF planning are weakly interrelated, indicating that countries invest in HWF in different ways. Determinant analysis shows that countries with larger health labour markets, National Healthcare Service (NHS), mobility, and strong primary health care score higher on HWF planning dimensions than others. Consequently, the results suggest that clustering countries with similar conditions in terms of HWF planning is a way forward towards mutual and contextual learning.
ATES COVERED 4. TITLE AND SUBTITLE S. FUNDING NUMBERS Total Quality Management Plan Technical and Logistics Services 6. AUTHOR(S) 7. PERFORMING...NUMBER OF PAGES TQM ( Total Quality Management ), Technical and Logistics Services, Continuous Process Improvement 16. PRICE CODE 17. SECURITY...Programs C-6 2. ’LFA a. DRMS C-6 b. Defense Supply Centers C-7 c. DLSC C-7 d. DTIC C-8 11. TOTAL QUALITY MANAGEMENT PLAN TECHNICAL AND LOGISTICS SERVICES
Bes, Romy E; Curfs, Emile C; Groenewegen, Peter P; de Jong, Judith D
In a health care system based on managed competition, health insurers negotiate on quality and price with care providers and are allowed to offer restrictive health plans. It is crucial that enrolees who need care choose restrictive health plans, as otherwise health insurers cannot channel patients to contracted providers and they will lose their bargaining power in negotiations with providers. We aim to explain enrolees' choice of a restrictive health plan in exchange for a lower premium. In 2014 an online survey with an experimental design was conducted on members of an access panel (response 78%; n=3,417). Results showed 37.4% of respondents willing to choose a restrictive health plan in exchange for a lower premium. This fell to 22% when the restrictive health plan also included a longer travelling time. Enrolees who choose a restrictive health plan are younger and healthier, or on lower incomes, than those preferring a non-restrictive one. This means that enrolees who use care will be unlikely to choose a restrictive health plan and, therefore, health insurers will not be able to channel them to contracted care providers. This undermines the goals of the health care system based on managed competition.
Grandal, Marta; Pernas, Berta; Mariño, Ana; Álvarez, Hortensia; Tabernilla, Andrés; Castro-Iglesias, Ángeles; Mena, Álvaro; Delgado, Manuel; Pértega, Sonia; Poveda, Eva
The aim of the study was to characterize HCV infection in Northwest Spain and assess the impact of the Spanish Strategic Plan to cure HCV infection. Overall, 387 patients were included (60.9% HIV/HCV coinfected and 28.2% cirrhotic). Of these, 72.9% of patients that were recognized as priority for HCV treatment according to the Spanish Strategic Plan (≥F2, transplant or extrahepatic manifestations), initiated treatment during 2015. Globally, SVR12 was achieved in 96.5% of patients. The implementation of the Spanish Strategic Plan has been critical to advance in HCV cure, but 27.1% of priority patients still remain awaiting HCV treatment initiation. This article is protected by copyright. All rights reserved.
Wakeley, P J; Marshall, S B; Foster, E C
In an increasingly information-based society, hospitals need a variety of information for multiple purposes--direct patient care, staff development and training, continuing education, patient and community education, and administrative decision support. Health science library and information services play a key role in providing broad-based information support within the hospital. This guide identifies resources that will help administrators plan information services that are appropriate to their needs.
... get about Medicare Lost/incorrect Medicare card Report fraud & abuse File a complaint Identity theft: protect yourself ... Medicare Covers Drug Coverage (Part D) Supplements & Other Insurance Claims & Appeals Manage Your Health Forms, Help & Resources ...
Wen-ji YANG; Bi-huan MAI; Min ZhOU; Qi-min SHI; Xin CAO; Wen-ying HE; Feng-ying ZOU; Xiao YING
Objective To understand the sexual and reproductive health knowledge among unmarried migrant population and their service demands as well as current services delivered by local family planning departments, so as to provide scientific evidences on conducting reproductive health education and appropriate service for migrant population in the district.Methods A questionnaire survey was conducted among a convenient sample of unmarried young migrant population between 15 and 25 years old in Dongshan District. All data were entered into database with the software Foxpro6.0 and analyzed with the statistics software SPSS10.0.Results Unmarried migrant population had some kinds of sexual and reproductive health knowledge and was eager to access to reproductive health service. They hoped that relevant governmental departments could provide them more information,education and service on sexuality and reproductive health.Conclusion Relevant departments should work together to popularize reproductive health knowledge among unmarried migrant population and meet their demands on reproductive health service, so as to improve their current reproductive health situation.
Grove, A L; Meredith, J O; Macintyre, M; Angelis, J; Neailey, K
This paper presents the findings of a 13-month lean implementation in National Health Service (NHS) primary care health visiting services from May 2008 to June 2009. Lean was chosen for this study because of its reported success in other healthcare organisations. Value-stream mapping was utilised to map out essential tasks for the participating health visiting service. Stakeholder mapping was conducted to determine the links between all relevant stakeholders. Waste processes were then identified through discussions with these stakeholders, and a redesigned future state process map was produced. Quantitative data were provided through a 10-day time-and-motion study of a selected number of staff within the service. This was analysed to provide an indication of waste activity that could be removed from the system following planned improvements. The value-stream map demonstrated that there were 67 processes in the original health visiting service studied. Analysis revealed that 65% of these processes were waste and could be removed in the redesigned process map. The baseline time-and-motion data demonstrate that clinical staff performed on average 15% waste activities, and the administrative support staff performed 46% waste activities. Opportunities for significant waste reduction have been identified during the study using the lean tools of value-stream mapping and a time-and-motion study. These opportunities include simplification of standard tasks, reduction in paperwork and standardisation of processes. Successful implementation of these improvements will free up resources within the organisation which can be redirected towards providing better direct care to patients.
The Veterinary Public Health Service and the National Organization for Nuclear Emergency Planning and Response in the Netherlands: Development of a measurement strategy in case of nuclear accidents. De Veterinaire Hoofdinspectie en het NPK: Ontwikkeling van een meetstrategie
Lembrechts, J.F.M.M.; Pruppers, M.J.M.
In this report the position of the Veterinary Public Health Service (VHI), which is part of the Ministry of Welfare, Health and Cultural Affairs, within the National Organisation for Nuclear Emergency Planning and Response (NPK), is evaluated. NPK is activated in case of nuclear accidents in order to describe and model the evolution of the environmental contamination, to advise on countermeasures and to supervise their application and effects. Within this organisation VHI has to organize or execute measurements on animals and veterinary products and to coordinate countermeasures pertaining to their field of work. The suggestion is made to integrate the tasks of VHI and those of the Inspectorate for Health Protection (IGB) and to attune the activities of VHI and those of the State Institute for Quality Control of Agricultural Products (RIKILIT). Advices are given on how to detail the tasks of VHI adequately in the context of NPK, amongst others by describing methods to collect and interpret data. It is suggested to firstly put into practice in vivo monitoring techniques for '3'I and [sup 134]Cs/[sup 137]Cs and to agree with other institutions on plans for sampling, sample preparation and measurements of milk. Finally a monitoring strategy for VHI is broadly outlined. It provides the framework for the definition of a detailed programme on sampling and measurement in case of a real accident. The monitoring strategy gives answers on the crucial question 'what has to be measured why and how by which person'. Since questions on where, when and how frequently measurements have to made should be tailored to the actual emergency situation, they are not dealt with in this report. 5 figs., 5 tabs., 66 refs.
Factors that health systems should consider when performing strategic assessments of their portfolios of ambulatory facilities include: Inventory. Location Facility condition. Service mix. Space use and capacity. Occupancy metrics. Strategic and economic opportunities.
Brocklehurst, Paul; Tickle, Martin
Background: The two most common models of workforce planning are the "stock and flow" and the demographic approach. The former balances future losses from a system against recruitment and retention, whilst the latter simply "grosses up" current provision based on changes to population demographics. However, such approaches…
Choy-Brown, Mimi; Hamovitch, Emily K; Cuervo, Carolina; Stanhope, Victoria
This study aimed to understand multiple stakeholder perspectives implementing a recovery-oriented approach to service planning in supportive housing programs serving people with lived experience of mental illnesses. Multiple stakeholders (N = 57) were recruited to participate in focus groups (N = 8), including 4 with tenants, 2 with service coordinators, 1 with supervisors, and 1 with leadership. Supportive housing programs were purposively sampled from a recovery-oriented organization serving 1,500 people annually. Stakeholders' experiences with service planning and implementing a recovery-oriented approach to service planning were explored. The authors conducted inductive thematic analyses combined with a conceptual matrix, which yielded themes across and within multiple stakeholder focus groups. Three themes emerged: (a) an institutional reminder-service planning experiences elicited negative emotions and served to remind people of experiences in institutional settings, (b) one-size-fits-all service planning-stakeholders perceived the use of quality assurance tools within the planning process as rigid to others' interests beyond their own, and (c) rules and regulations-reconciling funder requirements (e.g., completion dates) while also tailoring services to tenants' particular situations challenged providers. Even in a recovery-oriented organization, findings suggest that service planning in supportive housing has limitations in responding to each tenant's iterative recovery process. Further, in this context where people can make their home, stakeholders questioned whether the very presence of ongoing service planning activities is problematic. However, tenant-service coordinator relationships predicated on mutual respect and esteem overcame some service planning limitations. (PsycINFO Database Record (c) 2016 APA, all rights reserved).
The main objective of this thesis was to introduce three compatible integrated customer service templates for Stark according to the needs and wants of the customer service department. These providers all offer integrated technological solutions for multichannel services. This was done in order to improve work efficiency and thus have a positive effect on the customer experience. The purpose of the thesis was to find out what tools and programs the customer service representatives and the hea...
Mayhew, S H; Lush, L; Cleland, J; Walt, G
In the wake of the 1994 International Conference on Population and Development in Cairo, considerable activity has occurred both in national policymaking for reproductive health and in research on the implementation of the Cairo Program of Action. This report considers how effectively a key component of the Cairo agenda--integration of the management of sexually transmitted infections, including human immunodeficiency virus, with maternal and child health-family planning services--has been implemented. Quantitative and qualitative data are used to illuminate the difficulties faced by implementers of reproductive health programs in Ghana, Kenya, South Africa, and Zambia. In these countries, clear evidence is found of a critical need to reexamine the continuing focus on family planning services and the nature of the processes by which managers implement reproductive health policies. Implications of findings for policy and program direction are discussed.
Mutalemwa, Prince P; Kisinza, William N; Munga, Michael; Urassa, Janesta A E; Kibona, Stafford; Mwingira, Upendo; Lasway, Christina; Kilima, Stella; Tenu, Filemoni; Mujaya, Stella; Kisoka, William J
In Tanzania, reproductive health and HIV services are coordinated by the Ministry of Health and Social Welfare in two separate units namely Reproductive and Child Health Section and the National AIDS Control Programme. The importance of integrating the two services that are vertically run is expected to improve access to and uptake of key essential services and extend coverage to underserved and vulnerable populations and thus minimizing missed opportunities. Experts around the world recognize the central role of Sexual and Reproductive Health (SRH) services in preventing HIV infection. Evidence suggests that improving access to contraception for women to prevent pregnancy is an important and cost-effective way to prevent HIV-positive births. Integrating SRH and HlV services therefore verifies its importance for improving maternal and child health as well as leading to prevention of HIV infection. The primary objective of this review was to gain an understanding of the current linkages between SRH and HIV within Tanzania's policies, programmes, systems and services. Policy documents, guidelines, national laws, and published reports on SRH and HIV were reviewed. The majority of the reviewed documents mentioned fundamentals of integration between SRH and HIV. Majority of policies and guidelines both in family planning (FP) and HIV documents mandate bi-directional linkages. This review suggests that there are linkages between the two services and can be operationalised together. However, policies and guidelines only specify services to be integrated without due consideration of resources and structural orientation for linked services.
System of indexes and indicators for the quality evaluation of HACCP plans based on the results of the official controls conducted by the Servizio di Igiene degli Alimenti della Nutrizione (Food and Nutrition Health Service) of the Local Health Authority of Foggia, Italy.
Panunzio, Michele F; Antoniciello, Antonietta; Pisano, Alessandra
Within the realm of evaluating self-monitoring plans, developed based on the Hazard Analysis and Critical Control Points (HACCP) method and adopted by food companies, little research has been done concerning the quality of the plans. The Servizio di Igiene degli Alimenti e della Nutrizione (Food and Nutrition Health Service) of the Local Health Authority of Foggia, Italy, has conducted research with the aim to adopt a system of indexes and indicators for the qualitative evaluation of HACCP plans. The critical areas considered were the following: simplicity, specificity, feasibility and adherence. During the period from January 2004 to June 2005, the evaluation grid was used in examining 250 HACCP self-monitoring plans of food companies. For the analysis of the determining factor four groups were considered, with reference to HACCP self-monitoring plans designed: group 1 - with the aid of a qualified team; group 2 - with the aid of an unqualified team; group 3 - with the aid of an unqualified expert; group 4 - without the aid of an expert. The mean values of the measures elaborated decrease towards insufficiency moving from group 1 to group 4. In particular, collaboration by teams of unqualified experts brought about drafting unacceptable HACCP plans on the levels of specificity and adherence, with respect to the HACCP method. The method proposed of the analysis of the indexes and indicators beginning with an evaluation sheet can also help the individual company to better adjust contribution by internal or external professionals to the company.
Djarot S. Widyatmoko
Full Text Available Nowadays, the comprehensive and integrated rural development concept has been considered as the right approach in order to combat the root of rural poverty. By its main concern on area planning, i. e. the availability of planning apparatus at local (regional level, comprehensive local (rural resource analysis, and multi-disciplinary approach, it is expected that the weakneses of centralized planning which, among others, concentrates on economic growth can be reduced or even eliminated. This paper tries to explain the place of social service planning in the rural development concept above. The approach used is by discussing the place of service planning in the national development policies; collective decision making system, especially related to planning procedure and process; and social service problems in rural areas.
organi- zation, and external services (external timesharing and turnkey computer systems). Areas of impact are specific to the organization. The...timesharing vendors, changing services turnkey systems - potential and problems impacts and trends o distributed data processing technology needed...includes credit cards, automobile loans, personal and real estate loans, and leasing . Service improvements would aim at expediting credit review, payment
Sustainable growth and the commercial success of "Mainport Holland", located in one of Europe’s most densely populated areas, is threatened by a lack of available land, a congested infrastructure, and an increasingly complex social, economic and political reality. To deal with these threats mainports, such as the Port of Rotterdam, are reengineering their planning processes. Instead of making plans based on an extrapolation of current trends, the aim is now to find answers to ...
Scholz, Brett; Gordon, Sarah; Happell, Brenda
Contemporary mental health policies call for greater involvement of mental health service consumers in all aspects and at all levels of service planning, delivery, and evaluation. The extent to which consumers are part of the decision-making function of mental health organizations varies. This systematic review synthesizes empirical and review studies published in peer-reviewed academic journals relating to consumers in leadership roles within mental health organizations. The Cochrane Library, Medline, and PsycINFO were searched for articles specifically analysing and discussing consumers' mental health service leadership. Each article was critically appraised against the inclusion criteria, with 36 articles included in the final review. The findings of the review highlight current understandings of organizational resources and structures in consumer-led organizations, determinants of leadership involvement, and how consumer leadership interacts with traditional mental health service provision. It appears that organizations might still be negotiating the balance between consumer leadership and traditional structures and systems. The majority of included studies represent research about consumer-run organizations, with consumer leadership in mainstream mental health organizations being less represented in the literature. Advocates of consumer leadership should focus more on emphasizing how such leadership itself can be a valuable resource for organizations and how this can be better articulated. This review highlights the current gaps in understandings of consumer leadership in mental health, including a need for more research exploring the benefits of consumer leadership for other consumers of services. © 2016 Australian College of Mental Health Nurses Inc.
... Activities Prohibited § 2555.440 Health and insurance benefits and services. Subject to § 2555.235(d), in providing a medical, hospital, accident, or life insurance benefit, service, policy, or plan to any of its... 45 Public Welfare 4 2010-10-01 2010-10-01 false Health and insurance benefits and services....
... Programs and Activities Prohibited § 15a.39 Health and insurance benefits and services. In providing a medical, hospital, accident, or life insurance benefit, service, policy, or plan to any of its students, a... 7 Agriculture 1 2010-01-01 2010-01-01 false Health and insurance benefits and services....
... Prohibited § 106.39 Health and insurance benefits and services. In providing a medical, hospital, accident, or life insurance benefit, service, policy, or plan to any of its students, a recipient shall not... 34 Education 1 2010-07-01 2010-07-01 false Health and insurance benefits and services....
... Activities Prohibited § 196.440 Health and insurance benefits and services. Subject to § 196.235(d), in providing a medical, hospital, accident, or life insurance benefit, service, policy, or plan to any of its... 32 National Defense 2 2010-07-01 2010-07-01 false Health and insurance benefits and services....
....440 Health and insurance benefits and services. Subject to § 618.235(d), in providing a medical, hospital, accident, or life insurance benefit, service, policy, or plan to any of its students, a recipient... 45 Public Welfare 3 2010-10-01 2010-10-01 false Health and insurance benefits and services....
Sweeney, R E; Franklin, S P
This article illustrates how management in one type of service industry, the health maintenance organization (HMO), have attempted to formalize pricing. This effort is complicated by both the intangibility of the service delivered and the relatively greater influence in service industries of non-cost price factors such as accessibility, psychology, and delays. The presentation describes a simple computerized approach that allows the marketing manager to formally estimate the effect of incremental changes in rates on the firm's projected patterns of enrollment growth and net revenues. The changes in turn reflect underlying variations in the mix of pricing influences including psychological and other factors. Enrollment projections are crucial to the firm's financial planning and staffing. In the past, most HMO enrollment and revenue projections of this kind were notoriously unreliable. The approach described here makes it possible for HMOs to fine-tune their pricing policies. It also provides a formal and easily understood mechanism by which management can evaluate and reach consensus on alternative scenarios for enrollment growth, staff recruitment and capacity expansion.
Sheila Cristina Vargas
Full Text Available Background and Objectives: Health care for people with disabilities (PwD must be guaranteed by the state, health professionals and community involved, covering a multidisciplinary approach. This study aims to discuss the assistance to persons with disabilities in public health services. Method: This is a literature review of the descriptive study type with scientific publications on search sites Scielo, LILACS and Pubmed from descriptors: accessibility, people with disabilities, access to health services, totaling 514 articles, which fall under 22 the themes addressed. Results: Accessibility is a result of the availability of professionals and health services as well as access of Persons with Disabilities these services offered. We need planning actions by the multidisciplinary team, in order to seek to minimize the front inequalities behavioral barriers, architectural, geographical, which form gaps that prevent an egalitarian, unanimous and universal care as recommended by the health system. In oral health the principle of comprehensiveness includes the promotion, recovery and oral rehabilitation. Conclusion: Health promotion activities need to be encouraged so that it promotes the welfare of the health service user and that such actions occur in an integrated manner, adding resources from the comprehensive and multidisciplinary work. Accessibility to health services in conjunction with actions aimed at promoting the health of PwD can provide higher quality in health care and higher quality of life.
... HUMAN SERVICES Federal Health IT Strategic Plan: 2011-2015 Open Comment Period Extended Until Friday...: Notice. SUMMARY: The Federal Health IT Strategic Plan: 2011-2015 (``the Plan'') ] was posted on the ONC... considered, you must submit your comment via the Federal Health IT Buzz Blog:...
Quinn, Amity E; Reif, Sharon; Merrick, Elizabeth L; Horgan, Constance M; Garnick, Deborah W; Stewart, Maureen T
This study examined private health plans' arrangements for accessing and continuing specialty behavioral health treatment in 2010 as federal health reforms were being implemented. These management practices have historically been stricter in behavioral health care than in general medical care; however, the Mental Health Parity and Addiction Equity Act of 2010 required parity in management policies. The data source was a nationally representative survey of private health plans' behavioral health treatment management approaches in 2010. Health plan executives were asked about activities for their plan's three products with highest enrollment (weighted N=8,427, 88% response rate). Prior authorization for outpatient behavioral health care was rarely required (4.7% of products), but 75% of products required authorization for ongoing care and over 90% required prior authorization for other levels of care. The most common medical necessity criteria were self-developed and American Society of Addiction Medicine criteria. Nearly all products had formal standards to limit waiting time for routine and urgent treatment, but almost 30% lacked such standards for detoxification services. A range of wait time-monitoring approaches was used. Health plans used a variety of methods to influence behavioral health treatment entry and continuing care. Few relied on prior authorization for outpatient care, but the use of other approaches to influence, manage, or facilitate access was common. Results provide a baseline for understanding the current management environment for specialty behavioral health care. Tracking health plans' approaches over time will be important to ensure that access to behavioral health care is not prohibitively restrictive.
Keune, Hans; Oosterbroek, Bram; Derkzen, Marthe; Subramanian, Suneetha; Payyappalimana, Unnikrishnan; Martens, Pim; Huynen, Maud; Burkhard, Benjamin; Maes, Joachim
The practice of mapping ecosystem services (ES) in relation to health outcomes is only in its early developing phases. Examples are provided of health outcomes, health proxies and related biophysical indicators. This chapter also covers main health mapping challenges, design options and
Full Text Available Objective. Mental health service users experience high rates of cardiometabolic disorders and have a 20–25% shorter life expectancy than the general population from such disorders. Clinician-led health behavior programs have shown moderate improvements, for mental health service users, in managing aspects of cardiometabolic disorders. This study sought to potentially enhance health initiatives by exploring (1 facilitators that help mental health service users engage in better health behaviors and (2 the types of health programs mental health service users want to develop. Methods. A qualitative study utilizing focus groups was conducted with 37 mental health service users attending a psychosocial rehabilitation center, in Northern British Columbia, Canada. Results. Four major facilitator themes were identified: (1 factors of empowerment, self-value, and personal growth; (2 the need for social support; (3 pragmatic aspects of motivation and planning; and (4 access. Participants believed that engaging with programs of physical activity, nutrition, creativity, and illness support would motivate them to live more healthily. Conclusions and Implications for Practice. Being able to contribute to health behavior programs, feeling valued and able to experience personal growth are vital factors to engage mental health service users in health programs. Clinicians and health care policy makers need to account for these considerations to improve success of health improvement initiatives for this population.
Hans, Elias W.; van Houdenhoven, Mark; Hulshof, P.J.H.
Rising expenditures spur health care organizations to organize their processes more efficiently and effectively. Unfortunately, health care planning and control lags far behind manufacturing planning and control. Successful manufacturing planning and control concepts can not be directly copied,
... 45 Public Welfare 1 2010-10-01 2010-10-01 false Additional requirements for health plans. 162.925... requirements for health plans. (a) General rules. (1) If an entity requests a health plan to conduct a... payer). (c) Code sets. A health plan must meet each of the following requirements: (1) Accept and...
万方荣; 卢祖洵; 张金隆
Summary: Based on a survey of community health service organization in several cities, communi-ty health service model based on the family clinic was compared with state-owned communityhealth service model, and status quo, advantages and problems of family community health serviceorganization were analyzed. Furthermore, policies for the management of community health ser-vice organization based on the family clinic were put forward.
Sufrin, Carolyn; Baird, Sara; Clarke, Jennifer; Feldman, Elizabeth
Purpose Incarcerated women around the globe are predominantly of reproductive age. Most of these women have been pregnant before, and many want to be sexually active and avoid pregnancy upon release. Yet few of these women are on a regular method of contraception. Providing contraceptive services for women in custody benefits individual and public health goals of reducing unintended pregnancy. This policy briefing reviews evidence for an unmet need for family planning in the correctional setting, and policy implications for expanding services. The paper aims to discuss these issues. Design/methodology/approach The authors describe four model programs in the USA with established contraceptive services on site, highlighting practical steps other facilities can implement. Findings Correctional facilities health administrators, providers, advocates, and legislators should advance policies which should counsel women on family planning and should make a range of contraceptive methods available before release, while remaining sensitive to the potential pressure these women may feel to use birth control in this unique environment. Practical implications Family planning services for incarcerated women benefits individuals, facilities, and the community. Social implications Policies which enable correctional facilities to provide comprehensive family planning to incarcerated women - including reproductive life goals counseling and contraceptive method provision - promote equity in access to critical reproductive health services and also provide broad scale population level benefits in preventing unintended pregnancy or enabling counseling for healthy pregnancies for a group of women who often have limited access to such services. Originality/value This policy briefing highlights an area of health care in prisons and jails which gets little attention in research and in policy circles: family planning services for incarcerated women. In addition to reviewing the importance of
Full Text Available In South Africa, client satisfaction with the quality of health care has received minimal attention; probably due to the lack of locally developed and tested measures. Therefore, we developed and tested a 20-item attitude scale to determine satisfaction with Family Planning (FP services. The objectives of this study were to: ascertain reliability of the scale and confirm, through factor analysis, that satisfaction with the FP service was based on interpersonal and organisational dimensions. The sample comprised 199 black adult interviewees (158 women and 41 men, who had previously used or were currently using contraception, from an informal settlement in Gauteng, South Africa. Three items were removed from the scale due to unacceptable communality estimates. The reliability coefficient of 0.76 for the 17-item scale was satisfactory. The principal components analysis, with orthogonal and oblique rotations, extracted two factors; accounting for 51.8% of the variance. The highest loadings on Factor I involved an interpersonal dimension (friendly, encouraging, competent, informative and communicative. Factor II tended to focus on the organisational elements of the system, such as different methods, choice of methods, service availability and length of waiting time. It was concluded that this scale was a reliable, easily administered and scored measure of satisfaction, with underlying interpersonal and organisational dimensions.
Mondy, L W; Lutz, D B; Heartwell, S F; Zetzman, M R
The US Social Security Amendments of 1972 mandated the inclusion of family planning services in state Medicaid plans, authorized 90% of reimbursements for family planning care, and imposed financial penalties for failure to provide these services to Medicaid-eligible clients. On the other hand, many states have retrictive policies regarding Medicaid reimbursements to family planning agencies for services provided by physician extenders (e.g.s nurse practitioners and physician assistants). There is concern that such restrictions greatly reduce accessibility to family planning services. Reasons that hae been suggested as causes of such restrictive policies include physician concern over loss of income, the uncertain status of physician extenders in some states, a fear that this step will lead to a demand for reiimbursement for the services of other allied health care providers such as social workers, and concern that care for the indigent will lead to an expensive increase in state reimbursement for family planning services. However, a review of relevant federal law and regulations indicates that Medicaid reimbursement for services provided to eligible patients by physician extenders has never been prohibited or discouraged. Physician supervision is required in reimbursement cases, but this does not mean that a physician must be on the premises while services are delivered. The Medicaid program actually allows significant latitude in establishing administrative policies and procedures. Rather, problems faced by family planning agencies in receiving Medicaid reimbursements for physician extenders' services are due to restrictions in state laws and staff misinterpretations of policy. Research has demonstrated that physcian extenders can contribute significantly to cost effectiveness, while providing types of care in localities such as rural areas that physicians tend to avoid. Given the importance of family planning services to Medicaid-eligible clients, unwarranted
Jung, Mary-Louise; Loria, Karla
Objective: To investigate older people’s acceptance of e-health services, in order to identify determinants of, and barriers to, their intention to use e-health. Method: Based on one of the best-established models of technology acceptance, Technology Acceptance Model (TAM), in-depth exploratory interviews with twelve individuals over 45 years of age and of varying backgrounds are conducted. Results: This investigation could find support for the importance of usefulness and perceived ease of use of the e-health service offered as the main determinants of people’s intention to use the service. Additional factors critical to the acceptance of e-health are identified, such as the importance of the compatibility of the services with citizens’ needs and trust in the service provider. Most interviewees expressed positive attitudes towards using e-health and find these services useful, convenient, and easy to use. Conclusion: E-health services are perceived as a good complement to traditional health care service delivery, even among older people. These people, however, need to become aware of the e-health alternatives that are offered to them and the benefits they provide. PMID:21289860
Full Text Available Background and objectives : Health Services cost analyzing is an important management tool for evidence-based decision making in health system. This study was conducted with the purpose of cost analyzing and identifying the proportion of different factors on total cost of health services that are provided in urban health centers in Tabriz. Material and Methods : This study was a descriptive and analytic study. Activity Based Costing method (ABC was used for cost analyzing. This cross–sectional survey analyzed and identified the proportion of different factors on total cost of health services that are provided in Tabriz urban health centers. The statistical population of this study was comprised of urban community health centers in Tabriz. In this study, a multi-stage sampling method was used to collect data. Excel software was used for data analyzing. The results were described with tables and graphs. Results : The study results showed the portion of different factors in various health services. Human factors by 58%, physical space 8%, medical equipment 1.3% were allocated with high portion of expenditures and costs of health services in Tabriz urban health centers. Conclusion : Based on study results, since the human factors included the highest portion of health services costs and expenditures in Tabriz urban health centers, balancing workload with staff number, institutionalizing performance-based management and using multidisciplinary staffs may lead to reduced costs of services.
The successful implementation and operation of health care networks and the efficient and effective provision of health care services is dependent upon a number of different factors: Telecommunications infrastructure and technology, medical applications and services, user acceptance, education and training, product and applications/services development and service provision aspects. The business model and market development regarding policy and legal issues also must be considered in the development and deployment of telemedicine services to become an everyday practice. This chapter presents the initiatives, role and contribution of the Greek Telecommunications Company in the health care services area and also refers to specific case-studies focusing upon the key factors and issues of applications related to the telecommunications, informatics, and health care sectors, which can also be the drivers to create opportunities for Citizens, Society and the Industry.
Wendy V. Norman
Full Text Available Background. Providing equitable access to the full range of reproductive health services over wide geographic areas presents significant challenges to any health system. We present a review of a service provision model which has provided improved access to abortion care; support for complex issues experienced by women seeking nonjudgmental family planning health services; and a mechanism to collect information on access barriers. The toll-free pregnancy options service (POS of British Columbia Women’s Hospital and Health Centre sought to improve access to services and overcome barriers experienced by women seeking abortion. Methods. We describe the development and implementation of a province-wide toll-free telephone counseling and access facilitation service, including establishment of a provincial network of local abortion service providers in the Canadian province of British Columbia from 1998 to 2010. Results. Over 2000 women annually access service via the POS line, networks of care providers are established and linked to central support, and central program planners receive timely information on new service gaps and access barriers. Conclusion. This novel service has been successful in addressing inequities and access barriers identified as priorities before service establishment. The service provided unanticipated benefits to health care planning and monitoring of provincial health care related service delivery and gaps. This model for low cost health service delivery may realize similar benefits when applied to other health care systems where access and referral barriers exist.
Ohio State Dept. of Health, Columbus.
Guidelines are presented for planning a food service operation which is defined as any place kept or maintained for the purpose of preparing or serving meals or lunches for a consideration. Brief discussions are presented pertaining to the value of planning and the preparation and use of plans and specifications. Recommendations and specifications…
... 42 Public Health 5 2010-10-01 2010-10-01 false Health information technology planning advance planning document requirements (HIT PAPD). 495.336 Section 495.336 Public Health CENTERS FOR MEDICARE... Medicaid Program § 495.336 Health information technology planning advance planning document...
Crotty, Bradley H; Slack, Warner V
Patients are increasingly interacting with their healthcare system through online health services, such as patient portals and telehealth programs. Recently, Shabrabani and Mizrachi provided data outlining factors that are most important for users or potential users of these online services. The authors conclude convincingly that while online health services have great potential to be helpful to their users, they could be better designed. As patients and their families play an increasingly active role in their health care, online health services should be made easier for them to use and better suited to their health-related needs. Further, the online services should be more welcoming to people of all literacy levels and from all socioeconomic backgrounds.
Natalya Vasilyevna Krivenko
Full Text Available In the article, the definitions of the concept organizational and economic changes in institution problems of changes in public health service, the purpose and issues of the management system of organizational and economic changes in the field are considered. The combined strategy of development and innovative changes in management is offered. The need of resource-saving technologies implementation is shown. Expediency of use of marketing tools in a management system of organizational and economic changes is considered the mechanism of improvement of planning and pricing in public health service is offered. The author’s model of management of organizational and economic changes in health services supporting achievement of medical, social, economic efficiency in Yekaterinburg's trauma care is presented. Strategy of traumatism prevention is determined on the basis of interdepartmental approach and territorial segmentation of health care market
Mpunga, Dieudonné; Lumbayi, J P; Dikamba, Nelly; Mwembo, Albert; Ali Mapatano, Mala; Wembodinga, Gilbert
To determine the availability and quality of family planning services within health facilities throughout the Democratic Republic of the Congo (DRC). Data were collected for the cross-sectional study from April 2014 to June 2014 by the Ministry of Public Health. A total of 1,568 health facilities that reported data to the National Health Information System were selected by multistage random sampling in the 11 provinces of the DRC existing at that time. Data were collected through interviews, document review, and direct observation. Two dependent variables were measured: availability of family planning services (consisting of a room for services, staff assigned to family planning, and evidence of client use of family planning) and quality of family planning services (assessed as "high" if the facility had at least 1 trained staff member, family planning service delivery guidelines, at least 3 types of methods, and a sphygmomanometer, or "low" if the facility did not meet any of these 4 criteria). Pearson's chi-square test and odds ratios (ORs) were used to test for significant associations, using the alpha significance level of .05. We successfully surveyed 1,555 facilities (99.2%) of those included in the sample. One in every 3 facilities (33%) offered family planning services as assessed by the index of availability, of which 20% met all 4 criteria for providing high-quality services. Availability was greatest at the highest level of the health system (hospitals) and decreased incrementally with each health system level, with disparities between provinces and urban and rural areas. Facilities in urban areas were more likely than in rural areas to meet the standard for high-quality services (Pplanning services in health facilities in the DRC remain low, with inequitable distribution of services throughout the country. To improve access to and use of family planning, efforts should focus on improving availability and quality at lower health system levels and in
Constante i Beitia, Carles
The Department of Health of the Generalitat in Catalonia periodically draws up the Health Plan, which is the strategic document that brings together the reference framework for initiatives concerning public health in terms of the Catalan health administration. The 2011-2015 version of the Health Plan incorporates key care and system governance-related elements, which, in conjunction with health goals, make up the complete picture of what the health system in Catalonia should look like until 2015. The Plan was drawn up at a time when the environmental conditions were extremely particular, given the major economic crisis that began in 2007. This has meant that the system has been forced to address public health problems using a significant reduction in the economic resources available, while aiming to maintain the level of care provided, both quantitatively and qualitatively, and preserve the sustainability of the system whose defining traits are its universality, equity and the wide range of services on offer. The Health Plan focuses on three areas of action, 9 major courses of action and 32 strategic projects designed to respond to new social needs: addressing the most common health issues, comprehensive care for chronic patients and organizational modernization.
Africa.5,6 In Lesotho almost one-third of currently married ... Levels of awareness and utilisation of family planning services are high among female ..... use among young women in developing countries: a systematic review of qualitative.
Gray, R. M.
The historical base is presented for the framework plan for soil conservation. Conservation effects, resource management systems, and accomplishments, activities, and costs of the Soil Conservation Service are discussed.
Hester, Lorraine; O'Doherty, Lorna Jane; Schnittger, Rebecca; Skelly, Niamh; O'Donnell, Muireann; Butterly, Lisa; Browne, Robert; Frorath, Charlotte; Morgan, Craig; McLoughlin, Declan M; Fearon, Paul
To develop a quality of care instrument that is grounded in the service user perspective and validate it in a mental health service. The instrument (SEQUenCE (SErvice user QUality of CarE)) was developed through analysis of focus group data and clinical practice guidelines, and refined through field-testing and psychometric analyses. All participants were attending an independent mental health service in Ireland. Participants had a diagnosis of bipolar affective disorder (BPAD) or a psychotic disorder. Twenty-nine service users participated in six focus group interviews. Seventy-one service users participated in field-testing: 10 judged the face validity of an initial 61-item instrument; 28 completed a revised 52-item instrument from which 12 items were removed following test-retest and convergent validity analyses; 33 completed the resulting 40-item instrument. Test-retest reliability, internal consistency and convergent validity of the instrument. The final instrument showed acceptable test-retest reliability at 5-7 days (r = 0.65; P Service Satisfaction Scale (r = 0.84, P service user perspective and suitable for routine use. It may serve as a useful tool in individual care planning, service evaluation and research. The instrument was developed and validated with service users with a diagnosis of either BPAD or a psychotic disorder; it does not yet have established external validity for other diagnostic groups. © The Author 2015. Published by Oxford University Press in association with the International Society for Quality in Health Care; all rights reserved.
Dowd, B; Feldman, R
The data in Tables 1 through 4 show significant differences in the enrollment of higher health-related financial risk individuals and their families among health plans. FFS enrollees are older and exhibit more chronic illness on average. IPAs enroll a greater proportion of females than do PGP or FFS plans. PGPs and IPAs do not differ significantly in the age and chronic illness of their enrollees, but IPAs enroll a significantly greater proportion of females than do PGPs. The age difference between FFS and prepaid plans appears to be greater for long-term enrollees. The same pattern is true of chronic illness, but the results are often not statistically significant. We do not have time-series data, however, and cannot conclude that future comparisons among long-term enrollees will remains as they are now. In any care our data do not support the hypothesis that biased selection is a short-term problem that will be corrected as the population in prepaid plans ages. Our data contain a cross-section of environments for health plans in firms: long- and short-term offerings, long- and short-term enrollees, high and low out-of-pocket premium costs, etc. Our strongest results are the simplest: across all plans and environments there are significant differences in enrollee characteristics. These differences would not be inefficient if all groups paid actuarially fair premiums. However, mandatory offering and community-rating allow prepaid plans to enroll a younger population with less chronic illness and to maintain an information asymmetry that prevents employers and employees from determining--either prior to or following enrollment--the relationship of the prepaid plan's premium to its marginal cost.
Muhammed S. A. Masood
Full Text Available Background. The Yemeni government is focusing more attention on the needs of youth to ensure a healthy transition to adulthood. This is critical because adolescent population (ages 15–24 of 3.35 million will double in just 20 years. Young adults often lack basic knowledge about reproductive health and family planning. Objectives. To determine reproductive health and family planning knowledge and attitude among young adults aged 15 to 25+ years. Method. Sample study was taken from Marie Stopes International in Yemen which was conducted from March to July 2013 on the reproductive health age 15–49 years. Descriptive, bivariate, and multivariate analyses were employed. Results. Majority had heard about reproductive health and family planning and encouraged its methods. Television, relatives, and radio were major sources of information. Adults with higher education tend to have more awareness about health services. Knowledge about health services and family planning methods among older adults was significant, and adults in Belqees Club were more likely to have high empowerment scores for family planning methods. Conclusion. The level of knowledge about health services for reproductive health and family planning and its methods was low to moderate. The introduction of contraceptives remains a challenge in Yemen because the educational reproductive health is weak in Yemeni schools or health institutes or universities. Information about reproductive health and family planning should be provided to adolescents through medical schools curricula.
Krumm, Silvia; Becker, Thomas
User involvement in mental health services research is discussed in Great Britain, and a number of user-led research initiatives can be found. In Germany, less attention is paid to the concept while virtually no initiatives can be found. The concept of user involvement is introduced by reviewing the relevant literature. After discussion of theoretical and methodological implications, practicability of the concept for mental health services research is illustrated by some examples from Great Britain. User involvement in mental health services may promote the provision of user focused services. User involvement aims at the empowerment of mental health service users and can also improve the quality of mental health services research. Frequently, user-led/collaborative studies are focused on mental health service assessment. Some problematic aspects (e. g. representativeness, knowledge/skills of users) are discussed. Although more research is needed to document the additional benefit of user involvement in mental health services research it is conceivable that the concept will gain in importance.
Full Text Available The aim of this paper is to give a short description of the most important developments of mental health services in Finland during the 1990s, examine their influences on the organisation and provision of services, and describe shortly some national efforts to handle the new situation. The Finnish mental health service system experienced profound changes in the beginning of the 1990s. These included the integration of mental health services, being earlier under own separate administration, with other specialised health services, decentralisation of the financing of health services, and de-institutionalisation of the services. The same time Finland underwent the deepest economic recession in Western Europe, which resulted in cut-offs especially in the mental health budgets. Conducting extensive national research and development programmes in the field of mental health has been one typically Finnish way of supporting the mental health service development. The first of these national programmes was the Schizophrenia Project 1981–97, whose main aims were to decrease the incidence of new long-term patients and the prevalence of old long-stay patients by developing an integrated treatment model. The Suicide Prevention Project 1986–96 aimed at raising awareness of this special problem and decreasing by 20% the proportionally high suicide rate in Finland. The National Depression Programme 1994–98 focused at this clearly increasing public health concern by several research and development project targeted both to the general population and specifically to children, primary care and specialised services. The latest, still on-going Meaningful Life Programme 1998–2003 which main aim is, by multi-sectoral co-operation, to improve the quality of life for people suffering from or living with the threat of mental disorders. Furthermore, the government launched in 1999 a new Goal and Action Programme for Social Welfare and Health Care 2000–2003, in
MacDonald, Marlyse H
Virtual reference (VR) can be a successful vehicle for libraries if there is a demonstrated need by the user base for such a service and if the library staff believes in, accepts, and plans thoroughly for the concept. This article focuses on the experiences of the Duke University Medical Center Library (DUMCL) in planning, implementing, and using a virtual reference service utilizing LSSI's Virtual Reference Desk (VRD) Software.
Building on its experience as a principal participant in the President's Emergency Plan for AIDS Relief, the Department of Health and Human Services has embarked on a new era of global initiatives that ultimately will protect the health of Americans. The Global Health Strategy announced by health and human services secretary Kathleen Sebelius in January 2012 recognizes that the health of Americans is intertwined with that of the rest of the world. The initiative features ten objectives that range from enhanced global health surveillance and preventing infectious diseases and health threats to health diplomacy. The Global Health Strategy is designed to make optimal use of the department's many specialty agencies and their considerable technical and programmatic expertise. The strategy moves beyond the President's Emergency Plan for AIDS Relief to redefine Health and Human Services' role outside US borders in addressing the health challenges of the twenty-first century.
The 1994 International Conference on Population and Development developed international consensus amongst health providers, policy makers, and group representing the whole of civil society regarding the concept of reproductive health and its definition. In line with this definition, reproductive health care is defined as the constellation of methods, techniques and services that contribute to reproductive health and well-being by preventing and solving reproductive health problems. Reproductive health care saves lives and prevents significant levels of morbidity through family planning programmes, antenatal, delivery and post-natal services, prevention and management programmes for reproductive tract infections (including sexually transmitted diseases and HIV/AIDS), prevention of abortion and management of its complications, cancers of the reproductive system, and harmful practices that impact on reproductive function. Reproductive health care needs are evident at all stages of the life cycle and account for a greater proportion of disability adjusted life years (DALYS) in girls and women than in boys and men. Reproductive health protects infant health by enabling birth spacing and birth limitation to be practiced through family planning. The prevention and early detection of reproductive tract infections, including sexually transmitted diseases and HIV, through the integration of preventive measures in family planning service delivery not only improves the quality of care provided but is also directly responsible for improvement in survival and health of infants. Addressing harmful practices such as son preference, sex selection, sexual violence and female genital mutilation complements the positive impact of planned and spaced children through family planning services on infant mortality and the reproductive health of young girls and women. They are also in addition to prenatal, delivery and postnatal services, positive determinants of low maternal mortality and
Li Ying; Cheng Yi-ming; Huang Na; Guo Xin; Wang Xian-mi
This is a review of current situation of induced abortion and post abortion family planning service in China. Induced abortion is an important issue in reproductive health. This article reviewed the distribution of induced abortion in various time, areas, and population in China, and explored the character, reason, and harm to reproductive health of induced abortion.Furthermore, this article introduces the concept of Quality of Care Program in Family Planning,and discusses how important and necessary it is to introduce Quality of Care Program in Family Planning to China.
Kansas State Dept. of Social Welfare, Topeka. Div. of Institutional Management.
Summarized are the recommendations and findings of 1 1/2-year project to prepare a plan to combat mental retardation in Kansas. The study is said to have been based on the principle that needs rather than diagnostic labels should determine services provided. Outlined are mental retardation planning activities at the federal level and preplanning…
Buijs, Paul; Lopez Alvarez, Jose Alejandro; Veenstra, Marjolein; Roodbergen, Kees Jan
We study the collaborative transport planning for two autonomous business units of Fritom, a Dutch logistics service provider. This difficult planning problem does not fit any existing type of vehicle routing problem proposed in the academic literature; therefore, we define a new problem class, the
In Indonesia, the provision of family planning services to the community for a fee through a privately operated clinic is a relatively new concept. The idea to charge patients for family planning services came up during several meetings sponsored by the National Family Planning Coordinating Board (NFPCB) in its effort to increase family planning acceptance in urban areas. NFPCB realized that while the village family planning program was very effective, the urban family planning program was lagging behind for several reasons: while its services were free, most government-run clinics were open only in the morning, making it inconvenient for working mothers to avail themselves of the services; government operated clinics were crowded; since the services were free, they were perceived to be not of good quality; and there was a limited range of contraceptives and drugs available in the government operated clinics. In 1980, the Yayasan Kusuma Buana (YKB), a private nonprofit health and family planning organization in Jakarta, was asked by the Badan Koordenasi Keluarga Berencana Nasional (BKKBN) to set up a semi-commercial, urban family planning clinic as a pilot project. The clinic was established in an area where most of the residents belonged to the lower middle income group. After almost 3 years, the clinic became self-reliant and was used by the YKB as a basis for expanding the project. Currently, there are 9 such clinics in Jakarta and YKB is helping 10 other Indonesian cities to set up their own clinics. This paper considers the main components of YKB's strategy for planning and managing the clinic and and provides an analysis of the YKB experience in operating a successful family planning and maternal and child health program in the urban areas. To become self-reliant and at the same time have a successful family planning and health program, clinics should have the following characteristics: integrated services; competent and attractive clinic personnel; a
In developing countries the increasing tendency to charge for the use of health services is the result of the collapse of government funding for health programs and the general trend toward privatization. Restraints on government spending, especially on social programs, have been reinforced by loan conditions imposed by the International Monetary Fund and the World Bank. On the other hand, governments have committed themselves to the objectives of Health for All, and they have to maximize access to essential services for prevention and treatment of diseases. Charges are sometimes advocated as a means of reducing frivolous use of services. Studies have suggested that in Peru and rural Ivory Coast a modest rise in charges is likely to reduce use of services substantially for those on very low incomes, while those whose needs are the lest will continue to use services. Scarce facilities, skilled professionals, and other services provided at public expense are involved in the provision of basic health care. It is particularly difficult to recover the cost of training of doctors and nurses. Provision of technically advanced services for a minority who can afford to pay is almost always subsidized by governments and may deprive the rest of the population of key resources. The trend to introduce charges for family planning services and services for the treatment and prevention of communicable disease may have serious consequences. However, the collapse of government funding for health services in many developing countries requires alternative sources of funding for basic primary care. Some user charges may be justified, especially if these revenues result insubstantial improvements in the quality and availability of services. Development of feasible mechanisms for greater risk sharing in the longer term remains a priority if the most regressive effects of charges are to be avoided.
Beazoglou, T J; Guay, A H; Heffley, D R
Insurance carriers, corporations, and labor groups are actively developing and marketing dental capitation benefit plans. Incentives to both dentists and patients in these plans differ from those in the traditional fee-for-service system used with conventional benefit plans. This paper describes the likely effects of these incentive differences on utilization and service-mix patterns in both systems. Data for a large (approximately 10,000), homogenous group of subscribers are presented and discussed. Faced with a dual option, at no cost to the employee, 60% of the subscribers chose the fee-for-service plan, and 40% chose the capitation plan. Observed differences in the utilization and mix of services between the two plans cannot be explained solely in terms of dentists' responses. Employee response to altered economic incentives appears to be strong.
Lusi Herawati Sunyoto Usman Mark Zuidgeest
Full Text Available Equitable health care is a basic right for citizens and must be fulfilled by the government. This research analyzed communitydiscrepancy in access to reach health services in public hospitals and Puskesmas (health centers in Banyuwangi Regency.This research identified community accessibility to health facilities services using travel time and transport modes choiceas indicators. Flowmap tool is used to analyze catchment area of each health facility using different transport modes choice:becak and public transport for poor group and motorcycle and car for non-poor group with different travel time within 30, 60 and more than 60 minutes. It is concluded that there was an accessibility difference between poor and non-poor group. The accessibility to the health facilities of poor group was lower than non-poor group. This condition occurred because the government policy of equitable access to health service facility did not pay attention to accessibility of poor group.
Crawford, Gene M.
Outlines objectives and resources to be assessed in a community environmental health plan. Considers: water; liquid waste disposal; housing maintenance; solid waste disposal; air pollution; food and food protection; rodent control; insect control; migrant labor camps; recreation sites; mobile homes - trailer parks; schools, institutions - public…
Community mental health agencies often receive funds from a number of different sources with varying restrictions. Cash planning can help them manage these funds properly and avoid serious problems. The use of a projected cash flow statement may even help produce additional income for them.
Yuan, Mei-Hua; Lo, Shang-Lien; Yang, Chih-Kai
The purpose of this study is to estimate the benefits of ecosystem services for prioritization of land use conservation and to highlight the importance of ecosystem services by comparison between ecosystem service value and green GDP accounting. Based on land use pattern and benefit transfer method, this research estimated value of ecosystem services in Taiwan. Scientific information of land use and land cover change is accessed through multi-year satellite imagery moderate resolution imaging spectroradiometer (MODIS), and geographic information system (GIS) technology. Combined with benefit transfer method, this research estimated the ecosystem service valuation of forest, grassland, cropland, wetland, water, and urban for the period of 2000 to 2015 in Taiwan. It is found that forest made the greatest contribution and the significant increasing area of wetland has huge potential benefit for environmental conservation in Taiwan. We recommend placing maintaining wetland ecosystem in Taiwan with higher priority. This research also compared ecosystem service value with natural capital consumption which would essentially facilitate policy makers to understand the relationship between benefits gained from natural capital and the loss from human-made capital.
Hoge, Michael A; Morris, John A; Stuart, Gail W; Huey, Leighton Y; Bergeson, Sue; Flaherty, Michael T; Morgan, Oscar; Peterson, Janice; Daniels, Allen S; Paris, Manuel; Madenwald, Kappy
Across all sectors of the behavioral health field there has been growing concern about a workforce crisis. Difficulties encompass the recruitment and retention of staff and the delivery of accessible and effective training in both initial, preservice training and continuing education settings. Concern about the crisis led to a multiphased, cross-sector collaboration known as the Annapolis Coalition on the Behavioral Health Workforce. With support from the Substance Abuse and Mental Health Services Administration, this public-private partnership crafted An Action Plan for Behavioral Health Workforce Development. Created with input from a dozen expert panels, the action plan outlines seven core strategic goals that are relevant to all sectors of the behavioral health field: expand the role of consumers and their families in the workforce, expand the role of communities in promoting behavioral health and wellness, use systematic recruitment and retention strategies, improve training and education, foster leadership development, enhance infrastructure to support workforce development, and implement a national research and evaluation agenda. Detailed implementation tables identify the action steps for diverse groups and organizations to take in order to achieve these goals. The action plan serves as a call to action and is being used to guide workforce initiatives across the nation.
Jepson, Lisa; Juszczak, Linda; Fisher, Martin
Describes the mental-health and medical services provided at a high-school-based service center. Five years after the center's inception mental health visits had quadrupled. One third of students utilizing the center reported substance abuse within their family. Other reasons for center use included pregnancy, suicidal ideation, obesity,…
... Internal Revenue Service 26 CFR Parts 40, 46, and 602 RIN 1545-BK59 Fees on Health Insurance Policies and... issuers of certain health insurance policies and plan sponsors of certain self-insured health plans to...-3970 (regarding health insurance policies). SUPPLEMENTARY INFORMATION: Paperwork Reduction Act The...
Di Lallo, Domenico; Di Napoli, Anteo
Improving the well-being of infants and children is an important public health goal. To reach this objective public health authorities need in-depth knowledge of perinatal statistics as well as the organization of perinatal care. These data must be based on the use of reliable information describing both individual and organizational factors and short and long term outcomes. Several perinatal information sources are available in Italy for analyses aimed at producing evidence for health planning purposes: the National birth registry, Infant mortality registry and Neonatal networks. We describe their structure and summarize some evidence derived from the experiences conducted in the Lazio region.
Sohn, Minji; Barrett, Hope; Talbert, Jeffery
Kentucky Department for Behavioral Health Developmental and Intellectual Disabilities conducted a survey to evaluate consumers' satisfaction with services delivered at the Community Mental Health Centers (CMHCs) in Kentucky. The survey was administered at outpatient clinics operated by fourteen CMHCs in 2010. The purpose of this study was to identify factors that predict whether clients will respond that they were "generally satisfied" with services received from CMHCs. A logistic regression model was developed using respondents' characteristics and their responses to survey questions. Survey questions were grouped into seven core domains: general satisfaction, access, quality, participation in treatment planning, outcomes, functioning, and social connectedness. In result, responses to domains of access, quality and participation in treatment planning significantly affected clients' perception of general satisfaction. Respondents who positively assessed those domains of services were more likely to answer that they were generally satisfied with services. Based on the analysis in this report, improvement in certain domains of services, especially access, quality and participation in treatment planning could increase the level of positive responses in general satisfaction.
Kortteisto, Tiina; Laitila, Minna; Pitkänen, Anneli
Patient-centred care and user involvement in healthcare services are much emphasised globally. This study was the first step in a multicentre research project in Finland to improve service users' and carers' opportunities to be more involved in mental health services. The aim of the study was to assess attitudes of professionals towards service user involvement. The data were collected via an online questionnaire from 1069 mental health professionals in four hospital districts. Altogether, 351 professionals responded. Data were analysed using appropriate statistical methods. According to the results, attitudes of healthcare professionals were more positive towards service users' involvement in their own treatment than in other levels of services. There were also differences in gender, age groups, working places and experiences in the attitudes of professionals concerning service users' involvement in their own treatment. These should be taken into account in the future when planning education for mental health professionals. In spite of governmental guidance on service user involvement and the growing body of knowledge of the benefits associated with it, change in attitudes towards user involvement is slow. Special attention should be paid to the attitudes of professionals working in inpatient care and of those with less working experience. © 2017 Nordic College of Caring Science.
Perrott, Bruce E
This article will explore the concept and meaning of codesign as it applies to the delivery of health services. The results of a pilot study in health codesign will be used as a research based case discussion, thus providing a platform to suggest future research that could lead to building more robust knowledge of how the consumers of health services may be more effectively involved in the process of developing and delivering the type of services that are in line with expectations of the various stakeholder groups.
Abidi, S S; Yusoff, Z
The Malaysian Telemedicine initiative advocates a paradigm shift in healthcare delivery patterns by way of implementing a person-centred and wellness-focused healthcare system. This paper introduces the Malaysian Telemedicine vision, its functionality and associated operational conditions. In particular, we focus on the conceptualisation of one key Telemedicine component i.e. the Lifetime Health Plan (LHP) system--a distributed multimodule application for the periodic monitoring and generation of health-care advisories for all Malaysians. In line with the LHP project, we present an innovative healthcare delivery info-structure--LifePlan--that aims to provide life-long, pro-active, personalised, wellness-oriented healthcare services to assist individuals to manage and interpret their health needs. Functionally, LifePlan based healthcare services are delivered over the WWW, packaged as Personalised Lifetime Health Plans that allow individuals to both monitor their health status and to guide them in healthcare planning.
Adlung, R; Carzaniga, A
The potential for trade in health services has expanded rapidly in recent decades. More efficient communication systems have helped to reduce distance-related barriers to trade; rising incomes and enhanced information have increased the mobility of patients; and internal cost pressures have led various governments to consider possibilities for increased private participation. As yet, however, health services have played only a modest role in the General Agreement on Trade in Services (GATS). It is possible that Members of the World Trade Organization have been discouraged from undertaking access commitments by the novelty of the Agreement, coordination problems between relevant agencies, widespread inexperience in concepts of services trade, a traditionally strong degree of government involvement in the health sector, and concerns about basic quality and social objectives. However, more than five years have passed since GATS entered into force, allowing hesitant administrations to familiarize themselves with its main elements and its operation in practice. The present paper is intended to contribute to this process. It provides an overview of the basic structure of GATS and of the patterns of current commitments in health services and of limitations frequently used in this context. The concluding section discusses possibilities of pursuing basic policy objectives in a more open environment and indicates issues that may have to be dealt with in current negotiations on services.
Ana Caroline Gonçalves Cavalcante
Full Text Available This descriptive, exploratory and qualitative study was performed with the objective to evaluate the structure of the Mental Health Service Network of the Municipal Health Department of Goiania, the capital city of Goias state, Brazil. Data were collected using a semi-structured instrument and photographic records, and analyzed using Atlas.ti 6.2, and based on Donabedian’s theoretical framework. Various conditions were observed for service facilities; from structures that were precarious and unsuitable for therapy, to facilities that were welcoming and had good accessibility. The main positive aspect was the diversity of multidisciplinary teams. Making service facilities appropriate is imperative, although it is recognized that the municipality is currently undergoing reformulation, aiming at meeting the needs of the National Policy for Mental Health. Furthermore, intersectoral partnerships should be established for evaluation processes, particularly in the academia and service domains, which could generate the desired impact on health care to clients of specialized services. Descriptors: Health Services Evaluation; Mental Health; Structure of Services.
Leskinen, Salme; Häyrinen, Kristiina; Saranto, Kaija; Ensio, Anneli
It is often said that we are living in an information society and information technology (IT) is a normal part of life in many fields. But IT is not used effectively in health care. The purpose of this study was to survey what kind of Internet-based health services and related electronic services are offered to clients by the web-pages of health care organizations in Finland.
Rest, K M
In the rush to capture new segments of the health care market, occupational health services have become an attractive "product line" for some provider groups. However, providers may not appreciate the significant ethical dimensions of delivering occupational health services. The environment of the workplace gives rise to competing goals, interests, and expectations and creates thorny ethical issues for health care providers. It is important that providers develop a framework for recognizing and addressing these ethical issues and the influence of their own and other parties' values on their decision-making processes.
Ambegaokar, Maia; Lush, Louisiana
Advocates of health system reform are calling for, among other things, decentralized, autonomous managerial and financial control, use of contracting and incentives, and a greater reliance on market mechanisms in the delivery of health services. The family planning and sexual health (FP&SH) sector already has experience of these. In this paper, we set forth three typical means of service provision within the FP&SH sector since the mid-1900s: independent not-for-profit providers, vertical government programmes and social marketing programmes. In each case, we present the context within which the service delivery mechanism evolved, the management techniques that characterize it and the lessons learned in FP&SH that are applicable to the wider debate about improving health sector management. We conclude that the FP&SH sector can provide both positive and negative lessons in the areas of autonomous management, use of incentives to providers and acceptors, balancing of centralization against decentralization, and employing private sector marketing and distribution techniques for delivering health services. This experience has not been adequately acknowledged in the debates about how to improve the quality and quantity of health services for the poor in developing countries. Health sector reform advocates and FP&SH advocates should collaborate within countries and regions to apply these management lessons.
Furukawa, Shunichi; Fujieda, Yumiko; Shimizu, Kimiko; Ishibashi, Aya; Eguchi, Satoshi
Outreach services are very important in community mental health care. There are two types for outreach services. One is mental health activities, such as early intervention and consultation, and the other is intended to prevent recurrence and readmission by supporting the daily living activities of a patient in a community. We have 2.73 psychiatric care beds in hospitals per 1,000 population. So, it is just the beginning in changing from hospital centered psychiatry to community mental health care. Outreach services are being tried in several places in our country. In this essay, we describe mental health outreach services in Japan and we have illustrated vocational rehabilitation and outreach job support in our day treatment program.
Evaluation of Aboriginal Health Services (AHSs) has become a topic of importance to service providers and governments in recent years. This paper examines some of the difficulties AHSs have in conducting evaluation and presents an example of an inappropriate evaluation methodology as proposed by the Commonwealth Department of Aboriginal Affairs (DAA) in 1986. The paper examines the contradictory nature of the DAA proposal and the mistrust it has engendered in many AHSs. It then highlights some of the political difficulties in developing meaningful national and community health objectives as a basis for sound evaluation of health services. The paper concludes by identifying some of the processes whereby more appropriate evaluation methodologies might be developed and suggests that negotiation and consultation with the Aboriginal communities and their health services are imperative to successful evaluation.
Kulyk, Olga Anatoliyivna
In oktober heeft een workshop 'Kwaliteitseisen Digitale Hulpverlening in het Kader van e-health Sense' plaatsgevonden tijdens de digitale leerweek van Soa Aids Nederland en V&VN. Tijdens een focusgroepdiscussie met sociaal-verpleegkundigen seksuele gezondheid kwamen vragen aan de orde over het
Guerrero, Erick G; Harris, Lesley; Padwa, Howard; Vega, William A; Palinkas, Lawrence
Little is known about how the Affordable Care Act (ACA) will be implemented in publicly funded addiction health services (AHS) organizations. Guided by a conceptual model of implementation of new practices in health care systems, this study relied on qualitative data collected in 2013 from 30 AHS clinical supervisors in Los Angeles County, California. Interviews were transcribed, coded, and analyzed using a constructivist grounded theory approach with ATLAS.ti software. Supervisors expected several potential effects of ACA implementation, including increased use of AHS services, shifts in the duration and intensity of AHS services, and workforce professionalization. However, supervisors were not prepared for actions to align their programs' strategic change plans with policy expectations. Findings point to the need for health care policy interventions to help treatment providers effectively respond to ACA principles of improving standards of care and reducing disparities.
Poore, Sophie; Foster, Allen; Zondervan, Marcia; Blanchet, Karl
Over the past few decades diabetes has emerged as an important non-communicable disease in Sub-Saharan Africa (SSA). Sight loss from Diabetic Retinopathy (DR) can be prevented with screening and early treatment. The objective of this paper is to outline the required actions and considerations in the planning and development of DR screening services. A multiple-case study approach was used to analyse five DR screening services in Botswana, Ghana, Tanzania and Zambia. Cases included: two regional screening programmes, two hospital-based screening services and one nationwide screening service. Data was collected using qualitative methodologies including: document analysis, in-depth interviews and observation. The World Health Organization (WHO) Health Systems Framework was adopted as the conceptual framework for analysis. Planning for a sustainable and integrated DR screening programme demanded a health systems approach. Collaboration with representatives from a variety of ministerial departments and professional bodies was required. Evolution of DR screening services may occur in a variety of ways including: increasing geographical coverage, integration into the general healthcare system, and stepwise progression from a passive, opportunistic service to one that systematically and proactively seeks to prevent DR. Lessons learned from the implementation of cervical cancer prevention programmes in resource-poor settings may assist the development of DR programmes in similar settings. To promote good planning of DR screening services and ensure limited resources are used effectively, there is a need to learn from screening programmes in other medical specialities and a need to share experiences between newly-developing DR programmes in resource-poor countries. The WHO Health Systems Framework presents an invaluable tool to ensure a systematic approach to planning DR screening services.
Full Text Available Background Over the past few decades diabetes has emerged as an important non-communicable disease in SubSaharan Africa (SSA. Sight loss from Diabetic Retinopathy (DR can be prevented with screening and early treatment. The objective of this paper is to outline the required actions and considerations in the planning and development of DR screening services. Methods A multiple-case study approach was used to analyse five DR screening services in Botswana, Ghana, Tanzania and Zambia. Cases included: two regional screening programmes, two hospital-based screening services and one nationwide screening service. Data was collected using qualitative methodologies including: document analysis, indepth interviews and observation. The World Health Organization (WHO Health Systems Framework was adopted as the conceptual framework for analysis. Results Planning for a sustainable and integrated DR screening programme demanded a health systems approach. Collaboration with representatives from a variety of ministerial departments and professional bodies was required. Evolution of DR screening services may occur in a variety of ways including: increasing geographical coverage, integration into the general healthcare system, and stepwise progression from a passive, opportunistic service to one that systematically and proactively seeks to prevent DR. Lessons learned from the implementation of cervical cancer prevention programmes in resource-poor settings may assist the development of DR programmes in similar settings. Conclusion To promote good planning of DR screening services and ensure limited resources are used effectively, there is a need to learn from screening programmes in other medical specialities and a need to share experiences between newly-developing DR programmes in resource-poor countries. The WHO Health Systems Framework presents an invaluable tool to ensure a systematic approach to planning DR screening services.
Health insurance funds need the results of health services research more than ever due to the socio-legal and socio-economic conditions currently prevailing. This should be possible by taking transparency and data protection into consideration, by cooperating with outside researchers while ensuring flexible use of routine data and if necessary gathering additional data, and by establishing links to epidemiological and registry data. It should become normative to clear the way for health insurance funds to regularly include this type of research in budget planning and to this end provide access to a suitable source of funds. In conclusion, it can simply be stated that it no longer suffices to effectively make a new clinically tested procedure, product, and service available because health insurance funds and their partners must know more precisely what this all accomplishes in practice.
Danielsen, Solveig; Centeno, Julio; López, Julio
Establishing a few community-based plant clinics in Nicaragua led to a series of innovations in plant health service delivery. A grassroots experiment became a nationwide initiative involving local service providers, universities, research institutions and diagnostic laboratories. This led to the...
Warner, Mildred E; Xu, Yuanshuo; Morken, Lydia J
This study analyzes the links between planning, the built environment, and availability of health-related community services across U.S. urban and rural communities. We analyze the first national survey of health-related community services for seniors (2010 Maturing of America), covering 1,459 U.S. cities and counties. We tested the influence of morbidity (diabetes and obesity), city management, socioeconomic characteristics, planning and the built environment, metro status, and government finance. Community health-related services are more common in places that plan for and involve seniors in planning processes. Places with higher need and government capacity also show higher levels. Service levels in rural communities are not lower after controlling for other population characteristics. Morbidity measures (diabetes and obesity) do not explain differences in service availability. Policies promoting planning for aging and elder involvement in the planning process have the greatest impact on the level of community health-related services for seniors.
Merchant, Raina M; Finne, Kristen; Lardy, Barbara; Veselovskiy, German; Korba, Caey; Margolis, Gregg S; Lurie, Nicole
Health insurance plans serve a critical role in public health emergencies, yet little has been published about their collective emergency preparedness practices and policies. We evaluated, on a national scale, the state of health insurance plans' emergency preparedness and policies. A survey of health insurance plans. We queried members of America's Health Insurance Plans, the national trade association representing the health insurance industry, about issues related to emergency preparedness issues: infrastructure, adaptability, connectedness, and best practices. Of 137 health insurance plans queried, 63% responded, representing 190.6 million members and 81% of US plan enrollment. All respondents had emergency plans for business continuity, and most (85%) had infrastructure for emergency teams. Some health plans also have established benchmarks for preparedness (eg, response time). Regarding adaptability, 85% had protocols to extend claim filing time and 71% could temporarily suspend prior medical authorization rules. Regarding connectedness, many plans shared their contingency plans with health officials, but often cited challenges in identifying regulatory agency contacts. Some health insurance plans had specific policies for assisting individuals dependent on durable medical equipment or home healthcare. Many plans (60%) expressed interest in sharing best practices. Health insurance plans are prioritizing emergency preparedness. We identified 6 policy modifications that health insurance plans could undertake to potentially improve healthcare system preparedness: establishing metrics and benchmarks for emergency preparedness; identifying disaster-specific policy modifications, enhancing stakeholder connectedness, considering digital strategies to enhance communication, improving support and access for special-needs individuals, and developing regular forums for knowledge exchange about emergency preparedness.
Purcell, Rachael; McGirr, Joe
To determine health service managers' (HSMs) recommendations on strengthening the health service response to climate change. Self-administered survey in paper or electronic format. Rural south-west of New South Wales. Health service managers working in rural remote metropolitan areas 3-7. Proportion of respondents identifying preferred strategies for preparation of rural health services for climate change. There were 43 participants (53% response rate). Most respondents agreed that there is scepticism regarding climate change among health professionals (70%, n = 30) and community members (72%, n = 31). Over 90% thought that climate change would impact the health of rural populations in the future with regard to heat-related illnesses, mental health, skin cancer and water security. Health professionals and government were identified as having key leadership roles on climate change and health in rural communities. Over 90% of the respondents believed that staff and community in local health districts (LHDs) should be educated about the health impacts of climate change. Public health education facilitated by State or Federal Government was the preferred method of educating community members, and education facilitated by the LHD was the preferred method for educating health professionals. Health service managers hold important health leadership roles within rural communities and their health services. The study highlights the scepticism towards climate change among health professionals and community members in rural Australia. It identifies the important role of rural health services in education and advocacy on the health impacts of climate change and identifies recommended methods of public health education for community members and health professionals. © 2017 National Rural Health Alliance Inc.
Shung-Bin Yan; Feng-Jian Wang
Workflow management systems (WfMSs) are accepted worldwide due to their ability to model and control business processes. Previously, we defined an intra-organizational workflow specification model, Process LANguage (PLAN).PLAN, with associated tools, allowed a user to describe a graph specification for processes, artifacts, and participants in an organization. PLAN has been successfully implemented in Agentflow to support workflow (Agentflow) applications. PLAN,and most current WfMSs are designed to adopt a centralized architecture so that they can be applied to a single organization.However, in such a structure, participants in Agentflow applications in different organizations cannot serve each other with workflows.In this paper, a service-oriented cooperative workflow model, Cooperative Agentflow Process LANguage (CA-PLAN) is presented. CA-PLAN proposes a workflow component model to model inter-organizational processes. In CA-PLAN, an interorganizational process is partitioned into several intra-organizational processes. Each workflow system inside an organization is modeled as an Integrated Workflow Component (IWC). Each IWC contains a process service interface, specifying process services provided by an organization, in conjunction with a remote process interface specifying what remote processes are used to refer to remote process services provided by other organizations, and intra-organizational processes. An IWC is a workflow node and participant. An inter-organizational process is made up of connections among these process services and remote processes with respect to different IWCs. In this paper, the related service techniques and supporting tools provided in Agentflow systems are presented.
... From the Federal Register Online via the Government Publishing Office DEPARTMENT OF HEALTH AND HUMAN SERVICES Health Resources and Services Administration Statement of Organization, Functions and Delegations of Authority; Correction AGENCY: Health Resources and Services Administration (HRSA), HHS....
This work presents a development approach for mixed reality systems in health care. Although health-care service costs account for 5-15% of GDP in developed countries the sector has been remarkably resistant to the introduction of technology-supported optimizations. Digitalization of data storing and processing in the form of electronic patient records (EPR) and hospital information systems (HIS) is a first necessary step. Contrary to typical business functions (e.g., accounting or CRM) a health-care service is characterized by a knowledge intensive decision process and usage of specialized devices ranging from stethoscopes to complex surgical systems. Mixed reality systems can help fill the gap between highly patient-specific health-care services that need a variety of technical resources on the one side and the streamlined process flow that typical process supporting information systems expect on the other side. To achieve this task, we present a development approach that includes an evaluation of existing tasks and processes within the health-care service and the information systems that currently support the service, as well as identification of decision paths and actions that can benefit from mixed reality systems. The result is a mixed reality system that allows a clinician to monitor the elements of the physical world and to blend them with virtual information provided by the systems. He or she can also plan and schedule treatments and operations in the digital world depending on status information from this mixed reality.
System of Indexes and Indicators for the Quality Evaluation of HACCP Plans based on the Results of the Official Controls conducted by the Servizio di Igiene degli Alimenti della Nutrizione (Food and Nutrition Health Service of the Local Health Authority of Foggia, Italy
Full Text Available Within the realm of evaluating self-monitoring plans, developed based on the Hazard Analysis and Critical Control Points (HACCP method and adopted by food companies, little research has been done concerning the quality of the plans. The Servizio di Igiene degli Alimenti e della Nutrizione (Food and Nutrition Health Service of the Local Health Authority of Foggia, Italy, has conducted research with the aim to adopt a system of indexes and indicators for the qualitative evaluation of HACCP plans. The critical areas considered were the following: simplicity, specificity, feasibility and adherence. During the period from January 2004 to June 2005, the evaluation grid was used in examining 250 HACCP self-monitoring plans of food companies. For the analysis of the determining factor four groups were considered, with reference to HACCP self-monitoring plans designed: group 1 - with the aid of a qualified team; group 2 - with the aid of an unqualified team; group 3 - with the aid of an unqualified expert; group 4 Ã¢Â€Â“ without the aid of an expert. The mean values of the measures elaborated decrease towards insufficiency moving from group 1 to group 4. In particular, collaboration by teams of unqualified experts brought about drafting unacceptable HACCP plans on the levels of specificity and adherence, with respect to the HACCP method. The method proposed of the analysis of the indexes and indicators beginning with an evaluation sheet can also help the individual company to better adjust contribution by internal or external professionals to the company.
Rakićević, Zoran; Omerbegović-Bijelović, Jasmina; Lečić-Cvetković, Danica
This paper presents a model for effective planning of support services for small and medium-sized enterprises (SMEs). The idea is to scrutinize and measure the suitability of support services in order to give recommendations for the improvement of a support planning process. We examined the applied support services and matched them with the problems and needs of SMEs, based on the survey conducted in 2013 on a sample of 336 SMEs in Serbia. We defined and analysed the five research questions that refer to support services, their consistency with the SMEs' problems and needs, and the relation between the given support and SMEs' success. The survey results have shown a statistically significant connection between them. Based on this result, we proposed an eight-phase model as a method for the improvement of support service planning for SMEs. This model helps SMEs to plan better their requirements in terms of support; government and administration bodies at all levels and organizations that provide support services to understand better SMEs' problems and needs for support.
Office of Personnel Management — A list of all Federal Employees Health Benefits Program (FEHBP) plans available in each state, as well as links to the plan brochures, changes for each plan from the...
content of health sector strategic plans with the guidelines in selected countries of the ... providing different levels of comprehensiveness. ... health planning in the region, the World Health ... conditions and their distribution; health service and.
Birch, Stephen; Murphy, Gail Tomblin; MacKenzie, Adrian; Cumming, Jackie
The financial sustainability of publicly funded health care systems is a challenge to policymakers in many countries as health care absorbs an ever increasing share of both national wealth and government spending. New technology, aging populations and increasing public expectations of the health care system are often cited as reasons why health care systems need ever increasing funding as well as reasons why universal and comprehensive public systems are unsustainable. However, increases in health care spending are not usually linked to corresponding increases in need for care within populations. Attempts to promote financial sustainability of systems such as limiting the range of services is covered or the groups of population covered may compromise their political sustainability as some groups are left to seek private cover for some or all services. In this paper, an alternative view of financial sustainability is presented which identifies the failure of planning and management of health care to reflect needs for care in populations and to integrate planning and management functions for health care expenditure, health care services and the health care workforce. We present a Health Care Sustainability Framework based on disaggregating the health care expenditure into separate planning components. Unlike other approaches to planning health care expenditure, this framework explicitly incorporates population health needs as a determinant of health care requirements, and provides a diagnostic tool for understanding the sources of expenditure increase.
As part of an effort to lower energy consumption levels among individuals and small establishments that use energy, The Energy Extension Service, operating in ten pilot states, has implemented programs which focus on the particular needs of small businesses. These programs have been developed to deliver a range of services to the many different kinds of enterprises which fit into the small business category. The programs currently operating in the ten pilot states are described and examples are given. In Alabama, Auburn University provides information and analyses to test the feasibility of using alternative fuels for small businesses. In Connecticut, the Department of Commerce provides audits to businesses throughout the State. In Michigan, the Department of Commerce, through two contractors, provides seminars to one tenth of the small businesses in southeastern Michigan. In New Mexico, the small business program provides demonstration audits of small businesses using alternative energy sources. In Pennsylvania, EES, in connection with the Pennsylvania State University, provides technical assistance to small businesses throughout the State. In Tennessee, the program provides audits, seminars, and counseling services to small businesses in three of that state's counties. In Texas, the Texas A and M College of Engineering operates an information retrieval system for small manufacturers through a bi-monthly bulletin. In Seattle, Washington, the small business program provides audits to Mom and Pop type businesses in two of that city's neighborhoods. In Wisconsin, the University of Wisconsin provides seminars and audits to hospitality industry businesses. In Wyoming, the small business program provides seminars to firms in the building industry.
... § 1317.440 Health and insurance benefits and services. Subject to § 1317.235(d), in providing a medical, hospital, accident, or life insurance benefit, service, policy, or plan to any of its students, a recipient... 18 Conservation of Power and Water Resources 2 2010-04-01 2010-04-01 false Health and...
... Activities Prohibited § 3.440 Health and insurance benefits and services. Subject to § 3.235(d), in providing a medical, hospital, accident, or life insurance benefit, service, policy, or plan to any of its... 24 Housing and Urban Development 1 2010-04-01 2010-04-01 false Health and insurance benefits...
... Activities Prohibited § 1211.440 Health and insurance benefits and services. Subject to § 1211.235(d), in providing a medical, hospital, accident, or life insurance benefit, service, policy, or plan to any of its... 36 Parks, Forests, and Public Property 3 2010-07-01 2010-07-01 false Health and insurance...
....440 Health and insurance benefits and services. Subject to § 113.235(d), in providing a medical, hospital, accident, or life insurance benefit, service, policy, or plan to any of its students, a recipient... 13 Business Credit and Assistance 1 2010-01-01 2010-01-01 false Health and insurance benefits...
... Prohibited § 23.440 Health and insurance benefits and services. Subject to § 23.235(d), in providing a medical, hospital, accident, or life insurance benefit, service, policy, or plan to any of its students, a... 38 Pensions, Bonuses, and Veterans' Relief 2 2010-07-01 2010-07-01 false Health and...
Amaranto, Ernesto A.; Wepman, Barry J.
The five-year growth of an active Student Mental Health Service (SMHS) in an urban academic health center is described. The function of SMHS is limited strictly to therapeutic and consultative services for the students and operates as an outpatient treatment facility using a standard 12-session goal-oriented treatment plan. (LBH)
... 22 Foreign Relations 1 2010-04-01 2010-04-01 false Health and insurance benefits and services. 229... benefits and services. Subject to § 229.235(d), in providing a medical, hospital, accident, or life insurance benefit, service, policy, or plan to any of its students, a recipient shall not discriminate...
... 22 Foreign Relations 1 2010-04-01 2010-04-01 false Health and insurance benefits and services. 146... benefits and services. Subject to § 146.235(d), in providing a medical, hospital, accident, or life insurance benefit, service, policy, or plan to any of its students, a recipient shall not discriminate...
... 43 Public Lands: Interior 1 2010-10-01 2010-10-01 false Health and insurance benefits and services... benefits and services. Subject to § 41.235(d), in providing a medical, hospital, accident, or life insurance benefit, service, policy, or plan to any of its students, a recipient shall not discriminate...
... 6 Domestic Security 1 2010-01-01 2010-01-01 false Health and insurance benefits and services. 17... benefits and services. Subject to § 17.235(d), in providing a medical, hospital, accident, or life insurance benefit, service, policy, or plan to any of its students, a recipient shall not discriminate...
... 14 Aeronautics and Space 5 2010-01-01 2010-01-01 false Health and insurance benefits and services... benefits and services. Subject to § 1253.235(d), in providing a medical, hospital, accident, or life insurance benefit, service, policy, or plan to any of its students, a recipient shall not discriminate...
Hosking, Jamie; Macmillan, Alexandra; Connor, Jennie; Bullen, Chris; Ameratunga, Shanthi
Dependence on car use has a number of broad health implications, including contributing to physical inactivity, road traffic injury, air pollution and social severance, as well as entrenching lifestyles that require environmentally unsustainable energy use. Travel plans are interventions that aim to reduce single-occupant car use and increase the use of alternatives such as walking, cycling and public transport, with a variety of behavioural and structural components. This review focuses on organisational travel plans for schools, tertiary institutes and workplaces. These plans are closely aligned in their aims and intervention design, having emerged from a shared theoretical base. To assess the effects of organisational travel plans on health, either directly measured, or through changes in travel mode. We searched the following electronic databases; Transport (1988 to June 2008), MEDLINE (1950 to June 2008), EMBASE (1947 to June 2008), CINAHL (1982 to June 2008), ERIC (1966 to June 2008), PSYCINFO (1806 to June 2008), Sociological Abstracts (1952 to June 2008), BUILD (1989 to 2002), Social Sciences Citation Index (1900 to June 2008), Science Citation Index (1900 to June 2008), Arts & Humanities Index (1975 to June 2008), Cochrane Database of Systematic Reviews (to August 2008), CENTRAL (to August 2008), Cochrane Injuries Group Register (to December 2009), C2-RIPE (to July 2008), C2-SPECTR (to July 2008), ProQuest Dissertations & Theses (1861 to June 2008). We also searched the reference lists of relevant articles, conference proceedings and Internet sources. We did not restrict the search by date, language or publication status. We included randomised controlled trials and controlled before-after studies of travel behaviour change programmes conducted in an organisational setting, where the measured outcome was change in travel mode or health. Both positive and negative health effects were included. Two authors independently assessed eligibility, assessed trial
Gingrich, Newt; Hasan, Malik
The economic stimulus law of 2009 included incentive payments to encourage providers and hospitals to adopt and "meaningfully use" electronic health records. One resource was excluded from these regulations: patient data from the patient's health insurer, although health insurance companies tie together multiple sectors of the healthcare industry in a single patient-centered data form known as the claims history. They also have considerable experience with information technology (IT). As a result, they are uniquely positioned to move adoption of health IT systems forward. Health plan technologies should be included in the meaningful-use requirements. The result will be additional functionality, which in the end will improve quality, lower costs, and improve individual health.
Coutts, Christopher; Hahn, Micah
Contemporary ecological models of health prominently feature the natural environment as fundamental to the ecosystem services that support human life, health, and well-being. The natural environment encompasses and permeates all other spheres of influence on health. Reviews of the natural environment and health literature have tended, at times intentionally, to focus on a limited subset of ecosystem services as well as health benefits stemming from the presence, and access and exposure to, green infrastructure. The sweeping influence of green infrastructure on the myriad ecosystem services essential to health has therefore often been underrepresented. This survey of the literature aims to provide a more comprehensive picture-in the form of a primer-of the many simultaneously acting health co-benefits of green infrastructure. It is hoped that a more accurately exhaustive list of benefits will not only instigate further research into the health co-benefits of green infrastructure but also promote consilience in the many fields, including public health, that must be involved in the landscape conservation necessary to protect and improve health and well-being.
The way to provide medical services for dementia was reviewed in the context of the Comprehensive Strategy to Accelerate Dementia Measures (New Orange Plan). The basic structure of service providing system consists of the primary and secondary care services. Both are expected to function in the context of the community-based integrated care system. Because of regional differences, prefectural government should take measures to make the Medical Center for Dementia function depending on local circumstances. Psychiatric services and general hospitals are expected to provide mental health services and treatment for concurrent medical conditions, respectively. Home medical care is expected to be fundamental services for persons with advanced-stage dementia. In super-aging society, the standard medical service for older persons should be adapted to older persons living with dementia.
The general conditions influencing the quality assurance and audit in Polish occupational health services are presented. The factors promoting or hampering the implementation of quality assurance and audits are also discussed. The major influence on the transformation of Polish occupational health services in exorted by employers who are committed to cover the costs of the obligatory prophylactic examination of their employees. This is the factor which also contributes to the improvement of quality if services. The definitions of the most important terms are reviewed to highlight their accordance with the needs of occupational health services in Poland. The examples of audit are presented and the elements of selected methods of auditing are suggested to be adopted in Poland.
Jonge, Femke de; Roos, Nico; Herik, Jaap van den
This paper presents a protocol for plan health repair in multi-agent plan execution. Plan health repair aims at avoiding conflicts that might arise due to disruptions in the execution of a plan. This can be achieved by adjusting the executions of tasks instead of replanning the tasks. For this
Ameri, Cinzia; Fiorini, Fulvio
Marketing research is the systematic and objective search for, and analysis of, information relevant to the identification and solution of any problem in the field of marketing. The key words in this definition are: systematic, objective and analysis. Marketing research seeks to set about its task in a systematic and objective fashion. This means that a detailed and carefully designed research plan is developed in which each stage of the research is specified. Such a research plan is only considered adequate if it specifies: the research problem in concise and precise terms, the information necessary to address the problem, the methods to be employed in gathering the information and the analytical techniques to be used to interpret it. Maintaining objectivity in marketing research is essential if marketing management is to have sufficient confidence in its results to be prepared to take risky decisions based upon those results. To this end, as far as possible, marketing researchers employ the scientific method. The characteristics of the scientific method are that it translates personal prejudices, notions and opinions into explicit propositions (or hypotheses). These are tested empirically. At the same time alternative explanations of the event or phenomena of interest are given equal consideration.
Giotakos, O; Tsouvelas, G; Kontaxakis, V
Some studies have shown that access to mental health services can have an impact on mental health outcomes, including the suicide rates. The aim of the present study was to examine the relationship between regional and prefecture suicide rates (suicides per 100.000 residents) and both the number of primary and mental health-care service providers and the number of mental health infrastructures in Greece. Data were taken mainly from the Hellenic Statistical Authority (EL.STAT.) and the Ministry of Health for the period 2002-2009. Spearman correlations were used to examine the relationship between primary health-care, mental health providers and suicide rates per 100,000 residents at the prefecture, administrative region and geographical region levels. Men showed significantly higher suicide rates than women (U=-7.20, pGreece: Crete (4.76 vs 3.65), Thrace (4.45 vs 2.02) Central Greece (3.61 vs 1.39) Aegean Islands (3.03 vs 1.28). The highest correlations between suiciderutes and health services at the geographic regional level were found to be during the period 2007-2009, where suicide rates showed a significant negative correlation with privately practicing psychiatrists (rho=-0.71, pGreece. It should be noted that the running financial crisis in Greece seems to have many effects on quality of life, since the most common effects of an economic crisis are unemployment, spending power cuts,general insecurity and public spending retrenchment, including health related budget cuts. Having in mind the above situation, further analyses are needed to determine the relationship between mental health-care services, suicide rates and other psychosocial indices, in order to provide a strategic plan for a better design of mental health-care policy in Greece.
Silvey, Kerry; Stock, Jacquie; Hasegawa, Lianne E; Au, Sylvia Mann
Third party payers, funding agencies, and lawmakers often require clinicians and public health agencies to justify programs and services by documenting results. This article describes two assessment tools--"Defining Genetics Services Framework" and "Genetics Services Outcomes Menu," created to assist public health professionals, clinicians, family advocates, and researchers to plan, evaluate, and demonstrate the effectiveness of genetics services. The tools were developed by a work group of the Western States Genetics Services Collaborative (WSGSC) consisting of public health genetics and newborn screening professionals, family representatives, a medical geneticist, and genetic counselors from Alaska, California, Hawaii, Idaho, Oregon, and Washington. The work group created both tools by an iterative process of combining their ideas with findings from a literature and World Wide Web review. The Defining Genetics Services Framework reflects the diversity of work group members. Three over-lapping areas of genetics services from public health core functions to population screening to clinical genetics services are depicted. The Genetics Services Outcomes Menu lists sample long-term outcomes of genetics services. Menu outcomes are classified under impact areas of Knowledge and Information; Financing; Screening and Identification; Diagnosis, Treatment, and Management; and Population Health. The WSGSC incorporated aspects of both tools into their Regional Genetics Plan. 2009 Wiley-Liss, Inc.
Murphy, Gail Tomblin; Birch, Stephen; MacKenzie, Adrian; Rigby, Janet; Purkis, Mary Ellen
Clarifying the healthcare innovation agenda is critical in order to advance the impact of system innovations. As part of this agenda-setting it is important to address the four conditions within which innovations can enhance system sustainability: 1) the innovation agenda reflects and is aligned with healthcare objectives and policy; 2) planning methodologies for services, workforce and funding are aligned with healthcare objectives and policy; 3) innovations in services are accommodated in systems through innovations in policy, planning and funding; and 4) innovations are systematically monitored and evaluated. In order to illustrate these conditions, the authors present a case study of an evaluation of one Canadian Health Authority's efforts to transform healthcare delivery. This case study reveals that aligning innovations in policy, planning, funding and health services is critical to transforming health systems and that, in the absence of such alignment, sustainable health systems are difficult to achieve.
... 42 Public Health 1 2010-10-01 2010-10-01 false Health Service Delivery Areas. 136a.15 Section 136a... Receive Care? § 136a.15 Health Service Delivery Areas. (a) The Indian Health Service will designate and... Federal Indian reservations and areas surrounding those reservations as Health Service Delivery Areas....
Full Text Available One of the main objectives of military health services is to prevent suffering, injuries and death caused by wars which lead to great destructions on societies as much as possible. If the subject is considered for Turkish history, it is noted that personnel and duty processes of health services had an institutional feature and that duty was controlled by the government at Ottoman Empire. Public health practices, as a main component of military health services at both peace and war, has great importance. These practices should be determined thoroughly at peacetime by managers and preparations in that direction should be done and implemented. [TAF Prev Med Bull 2012; 11(1.000: 103-118
Ameri, Cinzia; Fiorini, Fulvio
The marketing mix is the combination of the marketing variables that a firm employs with the purpose to achieve the expected volume of business within its market. In the sale of goods, four variables compose the marketing mix (4 Ps): Product, Price, Point of sale and Promotion. In the case of providing services, three further elements play a role: Personnel, Physical Evidence and Processes (7 Ps). The marketing mix must be addressed to the consumers as well as to the employees of the providing firm. Furthermore, it must be interpreted as employees ability to satisfy customers (interactive marketing).
目的：通过了解计划怀孕人群优生知识知晓现状和优生需求，为计划怀孕夫妇提供有针对性的孕前优生健康教育使和优生保健服务.方法于2013年6－8月期间，使用同一调查问卷对参与国家免费孕前优生健康检查项目的1003名参检人员进行调查.结果优生知识总得分不及格率70．1％，良好13．2％.调查对象中能正确回答孕期绝对不能使用的疫苗仅12．8％.不同年龄、不同文化程度调查对象对优生知识知晓情况比较差异有统计学意义(P ＜0．05).调查对象中根据自己意愿希望生育宝宝的占86．0％；能做到花很多精力在孩子身上的占89.6％；参检人员对优生服务的需求率较高(96．0％).结论在开展优生保健服务工作中，应加强指导和教育，有针对性地向育龄参检人群宣传优生保健知识.%Objectives To understand the awareness situation of eugenic knowledge and the demand of eugenic service among population planning to get pregnant,and to provide targeted eugenic knowledge and eugenic service for this population.Methods 1 003 objects who participated in the National Free Pregnant Eugenics Health Check Program were surveyed by using the same questionnaire from June to August in 2013.Results The failing rate of the eugenics knowledge was 70.1%,and the good grade rate was 13.2%.Only 12.8% of the objects could correctly answer which vaccines could not be used absolutely during pregnancy.The awareness status of eugenics knowledge was different among different age,different cultural level objects (P <0.05).86.0% of the objects wanted to give birth based on their own willing,and 89.6% of the objects could spend a lot of vigor on children.The demand rate of eugenic service was high (96.0%).Conclusions The guidance and the education should be strengthened in the work of eugenics health services,and the targeted eugenic knowledge should be spread for the childbearing age pop-ulation.
DeLaet, David E; Shea, Steven; Carrasquillo, Olveen
OBJECTIVE We compare preventive services utilization among privately insured African Americans and Hispanics in managed care organizations (MCOs) versus fee-for-service (FFS) plans. We also examine racial/ethnic disparities in the receipt of preventive services among enrollees in FFS or MCO plans. DESIGN Analysis of the nationally representative 1996 Medical Expenditure Panel Survey. PARTICIPANTS Participants included 1,120 Hispanic, 929 African-American, and 6,383 non-Hispanic white (NHW) adults age 18 to 64 years with private health insurance. MEASUREMENTS AND MAIN RESULTS We examined self-reported receipt of physical examination, blood pressure measurement, cholesterol assessment, Papanicolau testing, screening mammography, and breast and prostate examinations. Multivariate modeling was used to adjust for age, gender, education, household income, and health status. Hispanics in MCOs were more likely than their FFS counterparts to report having preventive services, with adjusted differences ranging from 5 to 19 percentage points (P < .05 for physical examination, blood pressure measurement, breast examination and Pap smear). Among African Americans, such patterns were of a smaller magnitude. In both MCOs and FFS plans the proportion of African Americans reporting preventive services was equal to or greater than NHWs. In contrast, among Hispanic women in FFS, a non–statistically significant trend of fewer cancer screening tests than NHW's was observed (Pap smears 75% vs 80%; mammograms 66% vs 74%, respectively). In both MCO and FFS plans, Hispanics were less likely than NHWs to report having blood pressure and cholesterol measurement (P < .05). CONCLUSIONS With the demise of traditional MCOs, reform efforts should incorporate those aspects of MCOs that were associated with greater preventive service utilization, particularly among Hispanics. Existing ethnic disparities warrant further attention. PMID:12133160
... 41 Public Contracts and Property Management 1 2010-07-01 2010-07-01 true Health insurance, life insurance and other benefit plans. 60-300.25 Section 60-300.25 Public Contracts and Property Management..., life insurance and other benefit plans. (a) An insurer, hospital, or medical service company,...
... 41 Public Contracts and Property Management 1 2010-07-01 2010-07-01 true Health insurance, life insurance and other benefit plans. 60-250.25 Section 60-250.25 Public Contracts and Property Management..., life insurance and other benefit plans. (a) An insurer, hospital, or medical service company,...
... by USERRA? (a) USERRA defines a health plan to include an insurance policy or contract, medical or hospital service agreement, membership or subscription contract, or arrangement under which the employee's.... (c) USERRA covers multiemployer plans maintained pursuant to one or more collective bargaining...
Havlin, Linda J; McAllister, Michael F; Slavney, David H
Consumerism seeks to create a behavior change on the part of consumers so that they become accountable, knowledgeable and actively engaged in managing their health. It can be used in any existing health plan through targeted plan design changes and consumer education efforts. Employers have many options in addition to consumer-directed health plans (CDHPs).
Cost-effectiveness analysis of the national implementation of integrated community case management and community-based health planning and services in Ghana for the treatment of malaria, diarrhoea and pneumonia.
Escribano Ferrer, Blanca; Hansen, Kristian Schultz; Gyapong, Margaret; Bruce, Jane; Narh Bana, Solomon A; Narh, Clement T; Allotey, Naa-Korkor; Glover, Roland; Azantilow, Naa-Charity; Bart-Plange, Constance; Sagoe-Moses, Isabella; Webster, Jayne
Ghana has developed two main community-based strategies that aim to increase access to quality treatment for malaria, diarrhoea and suspected pneumonia: the integrated community case management (iCCM) and the community-based health planning and services (CHPS). The aim of the study was to assess the cost-effectiveness of these strategies under programme conditions. A cost-effectiveness analysis was conducted. Appropriate diagnosis and treatment given was the effectiveness measure used. Appropriate diagnosis and treatment data was obtained from a household survey conducted 2 and 8 years after implementation of iCCM in the Volta and Northern Regions of Ghana, respectively. The study population was carers of children under-5 years who had fever, diarrhoea and/or cough in the last 2 weeks prior to the interview. Costs data was obtained mainly from the National Malaria Control Programme (NMCP), the Ministry of Health, CHPS compounds and from a household survey. Appropriate diagnosis and treatment of malaria, diarrhoea and suspected pneumonia was more cost-effective under the iCCM than under CHPS in the Volta Region, even after adjusting for different discount rates, facility costs and iCCM and CHPS utilization, but not when iCCM appropriate treatment was reduced by 50%. Due to low numbers of carers visiting a CBA in the Northern Region it was not possible to conduct a cost-effectiveness analysis in this region. However, the cost analysis showed that iCCM in the Northern Region had higher cost per malaria, diarrhoea and suspected pneumonia case diagnosed and treated when compared to the Volta Region and to the CHPS strategy in the Northern Region. Integrated community case management was more cost-effective than CHPS for the treatment of malaria, diarrhoea and suspected pneumonia when utilized by carers of children under-5 years in the Volta Region. A revision of the iCCM strategy in the Northern Region is needed to improve its cost-effectiveness. Long-term financing
Hollar, M C
This article presents research findings useful in formulating a Best Practices Model for the delivery of mental health services to underserved minority populations. Aspects of the role of racism in health care delivery and public health planning are explored. An argument is made for inclusion of the legacy of the slavery experience and the history of racism in America in understanding the current health care crisis in the African-American population. The development of an outline in APA DSM IV for the use of cultural formulations in psychiatric diagnosis is discussed.
... Internal Revenue Service 26 CFR Parts 40 and 46 RIN 1545-BK59 Fees on Health Insurance Policies and Self... Patient Protection and Affordable Care Act on issuers of certain health insurance policies and plan sponsors of certain self-insured health plans to fund the Patient-Centered Outcomes Research Trust Fund...
Cardoso, M A; Poças, A; Silva, M S; Ribeiro, R; Almeida, M C; Brito, R S; Coelho, S T; Alegre, H
The requirement to provide urban water services continuously while infrastructures are ageing, imposes the need for increasingly sustainable infrastructure asset management (IAM). To achieve and maintain adequate levels of service, the AWARE-P IAM methodology has been applied in collaborative projects launched by the National Civil Engineering Laboratory, in partnership with IST (Technical University of Lisbon), Addition (software company) and several water utilities. The objective of these projects is to support urban water utilities in the development, implementation and maintenance of IAM plans. To guarantee the success of IAM planning, following the AWARE-P IAM methodology, utilities are required to: consider that the infrastructure has system behaviour and lifespan is indefinite and guarantee the full-alignment of IAM planning with organisation objectives. By analysing the strategic and tactical plans of participating utilities, the proposed methodology principles are discussed and supported. The main innovation results from the implementation of IAM planning are also presented and discussed, including the challenges of setting up an IAM process, together with the major benefits and drawbacks that come up when developing IAM plans. The results were demonstrated by the effective implementation of 16 strategic and 14 tactical IAM plans by the participating utilities.
Caradoc-Davies, T; Hawker, A
To establish the degree of implementation of the Strategic Planning Guidelines for Area Health Boards--Services for Adults with Physical Disability, published by the Department of Health in 1989, the services being provided, and the priorities for future service provision. Two postal surveys of area health boards (AHB's) were carried out in 1991. The first asked about the terminology of rehabilitation, administrative structure, advocacy, service audit, inventory of services, regional service delivery, and consultation processes. The second asked about the rehabilitation services provided, the type of disability of the consumers of the service, the reasons why services were or were not provided, the service gaps that existed, and the priorities that existed to fill those service gaps. The major finding was that while all area health boards adopted the rehabilitation concepts in principle, service development was impeded in many cases by the failure to provide resources to plan and develop the service. Some were providing comprehensive services. Most AHB's provided services for people with physical or multiple disabilities. All provided statutory services such as district nursing and home help, while most provided regular medical reviews, physiotherapy, occupational therapy, speech therapy, etc. Only about half provided attendant care, driving assessment, and swimming for people with disabilities, while less than half supported disability information services (DIS). Attendant care was seen as high priority to fill gaps in service, but was seen as the funding responsibility of the Department of Social Welfare. Service provision reflected a traditional approach to the provision of rehabilitation services. The development of innovative service delivery will require crown health enterprises to reevaluate their present level of commitment to rehabilitation services and to assess the effectiveness of reallocating some funds from acute services into rehabilitation.
The enormous variety of diagnoses and prescriptions for dealing with the health care crisis in the United States can be simplified and clarified by reference to four logically distinct models of methods for organizing the production of health services. The assumptions of the free market model, the bureaucratic planning model, the professional model and the cooperative equalitarian model are described, as are the characteristic pathologies connected with the form those models take in reality. The intrinsically expansionist character of the manufacturing, service and consumer segments of the U.S. health system is described and the suggestion made that legislative attempts to contain costs will lead to increased bureaucratization primarily at the expense of the consumer.
Jancloes, Michel; Thomson, Madeleine; Costa, María Mánez; Hewitt, Chris; Corvalan, Carlos; Dinku, Tufa; Lowe, Rachel; Hayden, Mary
A high level expert panel discussed how climate and health services could best collaborate to improve public health. This was on the agenda of the recent Third International Climate Services Conference, held in Montego Bay, Jamaica, 4-6 December 2013. Issues and challenges concerning a demand led approach to serve the health sector needs, were identified and analysed. Important recommendations emerged to ensure that innovative collaboration between climate and health services assist decision-making processes and the management of climate-sensitive health risk. Key recommendations included: a move from risk assessment towards risk management; the engagement of the public health community with both the climate sector and development sectors, whose decisions impact on health, particularly the most vulnerable; to increase operational research on the use of policy-relevant climate information to manage climate- sensitive health risks; and to develop in-country capacities to improve local knowledge (including collection of epidemiological, climate and socio-economic data), along with institutional interaction with policy makers.
Dee, Cheryl R; Newhouse, Joshua D
Digital reference service adds a valuable new dimension to health science reference services, but the road to implementation can present questions that require carefully considered decisions. This article incorporates suggestions from the published literature, provides tips from interviews with practicing academic health science librarians, and reports on data from students' exploration of academic health science library Web sites' digital reference services. The goal of this study is to provide guidelines to plan new services, assess user needs, and select software, and to showcase potential benefits of collaboration and proactive and user-friendly marketing. In addition, tips for successful operation and evaluation of services are discussed.
Blashki, Grant; Armstrong, Greg; Berry, Helen Louise; Weaver, Haylee J; Hanna, Elizabeth G; Bi, Peng; Harley, David; Spickett, Jeffery Thomas
Although the implications of climate change for public health continue to be elucidated, we still require much work to guide the development of a comprehensive strategy to underpin the adaptation of the health system. Adaptation will be an evolving process as impacts emerge. The authors aim is to focus on the responses of the Australian health system to health risks from climate change, and in particular how best to prepare health services for predicted health risks from heat waves, bushfires, infectious diseases, diminished air quality, and the mental health impacts of climate change. In addition, the authors aim to provide some general principles for health system adaptation to climate change that may be applicable beyond the Australian setting. They present some guiding principles for preparing health systems and also overview some specific preparatory activities in relation to personnel, infrastructure, and coordination. Increases in extreme weather-related events superimposed on health effects arising from a gradually changing climate will place additional burdens on the health system and challenge existing capacity. Key characteristics of a climate change-prepared health system are that it should be flexible, strategically allocated, and robust. Long-term planning will also require close collaboration with the nonhealth sectors as part of a nationwide adaptive response.
Rudolph, L; Deitchman, S; Dervin, K
Despite the human and monetary costs of occupational injury and illness, occupational health care has focused more on treatment than prevention, and prevention is not part of many clinical occupational health practices. This represents a failure of occupational health care to meet the health care needs of the working patients. MEDLINE searches were conducted for literature on occupational medical treatment and the prevention of occupational injury and illness were reviewed to for linkages between prevention and treatment. Policy discussions which identify examples of programs that integrated prevention and treatment were included. Although examples of the integration of clinical and preventive occupational health services exist, there are challenges and barriers to such integration. These include inaction by clinicians who do not recognize their potential role in prevention; the absence of a relationship between the clinician and an employer willing to participate in prevention; economic disincentives against prevention; and the absence of tools that evaluate clinicians on their performance in prevention. Research is needed to improve and promote clinical occupational health preventive services. Copyright 2001 Wiley-Liss, Inc.
Benjamin, D W
The purpose of this Plan is to outline the minimum health and safety requirements to which all participating Lawrence Livermore National Laboratory (LLNL) and non-LLNL employees (excluding National Ignition Facility [NIF] specific contractors and subcontractors covered under the construction subcontract packages (e.g., CSP-9)-see Construction Safety Program for the National Ignition Facility [CSP] Section I.B. ''NIF Construction Contractors and Subcontractors'' for specifics) shall adhere to for preventing job-related injuries and illnesses during Conventional Facilities construction activities at the NIF Project. For the purpose of this Plan, the term ''LLNL and non-LLNL employees'' includes LLNL employees, LLNL Plant Operations staff and their contractors, supplemental labor, contract labor, labor-only contractors, vendors, DOE representatives, personnel matrixed/assigned from other National Laboratories, participating guests, and others such as visitors, students, consultants etc., performing on-site work or services in support of the NIF Project. Based upon an activity level determination explained in Section 1.2.18, in this document, these organizations or individuals may be required by site management to prepare their own NIF site-specific safety plan. LLNL employees will normally not be expected to prepare a site-specific safety plan. This Plan also outlines job-specific exposures and construction site safety activities with which LLNL and non-LLNL employees shall comply.
Health services in developing countries face a crisis of recurrent costs. Far from being able to fund primary health care (PHC) developments, governments now have difficulty in keeping existing health services in operation. This article proposes an approach to the problem based on the proactive planning and management of recurrent health expenditure. The system addresses existing services as well as future plans and allows explicit trade-offs to be made in resource allocation. This may be termed 'recurrent-expenditureled planning'. The article describes a diagnostic health sector review, which incorporates a recurrent expenditure profile in four planes: by type of provider, source of finance, level of care and recipient population group. A fifth dimension of time trends for certain expenditure categories can be added. The steps of a strategic planning cycle for health services resources are then described, which allows health service strategies to be tested for broad economic feasibility. It also results in the establishment of resource targets that can act as benchmarks against which actual levels of funding can be compared. The targets help to maintain sectoral priorities in resource allocation even in times of economic constraint and to channel funds preferentially to localities and facilities in greatest need. The system calls for innovations in the methods of health planning and financial management in the health sector. Implementation will require health systems action-research at the country level. The essential purpose is to promote PHC policy-led resource allocation and use. No amount of planning can substitute for political action to realize 'health for all', but this system provides technical support to the political forces in favour of distributive PHC policies.
Pflaum, B B; Rivers, J S
Each year health care fraud drains millions of dollars from employer-sponsored health plans. Historically, employers have taken a rather tolerant view of fraud. As the pressure to manage health plan costs increases, however, many employers are beginning to see the detection and prosecution of fraud as an appropriate part of a cost management program. Fraud in medical insurance covers a wide range of activities in terms of cost and sophistication--from misrepresenting information on a claim, to billing for services never rendered, to falsifying the existence of an entire medical organization. To complicate matters, fraudulent activities can emanate from many, many sources. Perpetrators can include employees, dependents or associates of employees, providers and employees of providers--virtually anyone able to make a claim against a plan. This article addresses actions that employers can take to reduce losses from fraud. The first section suggests policy statements and administrative procedures and guidelines that can be used to discourage employee fraud. Section two addresses the most prevalent form of fraud--provider fraud. To combat provider fraud, employers should set corporate guidelines and should enlist the assistance of employees in identifying fraudulent provider activities. Section three suggests ways to improve fraud detection through the claims payment system--often the first line of defense against fraud. Finally, section four discusses the possibility of civil and criminal remedies and reviews the legal theories under which an increasing number of fraud cases have been prosecuted.
Green, Jennifer Greif; McLaughlin, Katie A.; Alegria, Margarita; Costello, E. Jane; Gruber, Michael J.; Hoagwood, Kimberly; Leaf, Philip J.; Olin, Serene; Sampson, Nancy A.; Kessler, Ronald C.
Objective: Although schools are identified as critical for detecting youth mental disorders, little is known about whether the number of mental health providers and types of resources that they offer influence student mental health service use. Such information could inform the development and allocation of appropriate school-based resources to…
Full Text Available In 2014, a series of reforms, called as the Health Sector Evolution Plan (HSEP, was launched in the health system of Iran in a stepwise process. HSEP was mainly based on the fifth 5-year health development national strategies (2011-2016. It included different interventions to: increase population coverage of basic health insurance, increase quality of care in the Ministry of Health and Medical Education (MoHME affiliated hospitals, reduce out-of-pocket (OOP payments for inpatient services, increase quality of primary healthcare, launch updated relative value units (RVUs of clinical services, and update tariffs to more realistic values. The reforms resulted in extensive social reaction and different professional feedback. The official monitoring program shows general public satisfaction. However, there are some concerns for sustainability of the programs and equity of financing. Securing financial sources and fairness of the financial contribution to the new programs are the main concerns of policy-makers. Healthcare providers’ concerns (as powerful and influential stakeholders potentially threat the sustainability and efficiency of HSEP. Previous experiences on extending health insurance coverage show that they can lead to a regressive healthcare financing and threat financial equity. To secure financial sources and to increase fairness, the contributions of people to new interventions should be progressive by their income and wealth. A specific progressive tax would be the best source, however, since it is not immediately feasible, a stepwise increase in the progressivity of financing must be followed. Technical concerns of healthcare providers (such as nonplausible RVUs for specific procedures or nonefficient insurance-provider processes should be addressed through proper revision(s while nontechnical concerns (which are derived from conflicting interests must be responded through clarification and providing transparent information. The
Moradi-Lakeh, Maziar; Vosoogh-Moghaddam, Abbas
In 2014, a series of reforms, called as the Health Sector Evolution Plan (HSEP), was launched in the health system of Iran in a stepwise process. HSEP was mainly based on the fifth 5-year health development national strategies (2011-2016). It included different interventions to: increase population coverage of basic health insurance, increase quality of care in the Ministry of Health and Medical Education (MoHME) affiliated hospitals, reduce out-of-pocket (OOP) payments for inpatient services, increase quality of primary healthcare, launch updated relative value units (RVUs) of clinical services, and update tariffs to more realistic values. The reforms resulted in extensive social reaction and different professional feedback. The official monitoring program shows general public satisfaction. However, there are some concerns for sustainability of the programs and equity of financing. Securing financial sources and fairness of the financial contribution to the new programs are the main concerns of policy-makers. Healthcare providers' concerns (as powerful and influential stakeholders) potentially threat the sustainability and efficiency of HSEP. Previous experiences on extending health insurance coverage show that they can lead to a regressive healthcare financing and threat financial equity. To secure financial sources and to increase fairness, the contributions of people to new interventions should be progressive by their income and wealth. A specific progressive tax would be the best source, however, since it is not immediately feasible, a stepwise increase in the progressivity of financing must be followed. Technical concerns of healthcare providers (such as nonplausible RVUs for specific procedures or nonefficient insurance-provider processes) should be addressed through proper revision(s) while nontechnical concerns (which are derived from conflicting interests) must be responded through clarification and providing transparent information. The requirements of
Keywords: Mobile clinics; Staic clinic; Family planning; Cost-effectiveness. Résumé ... revealed surprisingly low use of mobile clinic services ... provider point of view. Cost data ..... this is an even more attractive strategy than tying free IUDs to ...
Villalba, E.; Casas, I.; Abadie, F.
Objectives: The deployment and adoption of Integrated Personal Health and Care Services in Europe has been slow and fragmented. There have been many initiatives and projects of this kind in different European regions, many of which have not gone beyond the pilot stage. We investigated the necessary...... conditions for mainstreaming these services into care provision. Methods: We conducted a qualitative analysis of 27 Telehealth, Telecare and Integrated Personal Health System projects, implemented across 20 regions in eight European countries. The analysis was based on Suter’s ten key principles...... for successful health systems integration. Results: Out of the 27 cases, we focused on 11 which continued beyond the pilot stage. The key facilitators that are necessary for successful deployment and adoption in the European regions of our study are reorganisation of services, patient focus, governance...
Angela P Vivanti
Full Text Available Aims Assessment and Planning Units have increased globally however, models of care literature is limited. With high malnutrition prevalence amongst ageing populations, this case report identifies demands for dietetic services. Methods Descriptive data compared and contrasted two service including medical models, eligibility criteria, malnutrition screening, dietetic services, clinical follow-up, and team composition. Results High malnutrition prevalence (17 per cent, 31 per cent was evident with different screening approaches successfully implemented. Both units favoured rapid assessment and intervention. Conclusion Dietetic expertise was required for malnutrition assessment, and ongoing management in acute or community setting as determined by differing health-care system arrangements
Meilman, P W
To provide first-rate services to students, college health services need the best possible staff. Managers and supervisors play a critical role in guiding the work of their employees so as to enhance performance. Reference checks for new employees and regular performance appraisal dialogues for ongoing employees are important tools in this process. The author discusses these issues and suggests formats for reference checks and performance appraisals.
Lopes, P M; Nichols, A W
The concept of a health service district, as a variation of the special tax district, is described and discussed. Tax districts have traditionally been used to support both capital construction (revenue bonds) and operational expenses of single-purpose governmental entities. The health service district, where authorized by state laws, may be used by local areas to subsidize the delivery of ambulatory health care. A particular case, the Ajo-Lukeville Health Service District in Arizona, illustrates what can be accomplished by this mechanism with the cooperation of local residents and outside agencies. Both the process of establishing such a district and the outcome of the Ajo-Lukeville experience is described. Reasons why health service districts may prove potentially attractive at this time are reviewed. Impediments to the development of more health service districts are also explored, including the lack of technical assistance, an inadequate awareness of the potential of health service districts, and the absence of a widespread orientation toward community financed and controlled health care. Movement in this direction should facilitate the development of additional health service districts.
Full Text Available Unwelcoming behaviours and judgemental attitudes have long been recognised as a barrier to young people's access to reproductive health services. Over the last decade youth friendly reproductive health services have been promoted and implemented world-wide. However, long term evidence of the impact of these programmes is lacking. We report the results of a large mystery client evaluation of adolescent sexual and reproductive health services in Tanzania, a country that has had a long established youth friendly policy. Forty-eight visits made to thirty-three health facilities were conducted by twelve young people (six in each region trained to perform three different scripted scenarios (i.e., condom request, information on sexually transmitted infections and family planning. The study revealed barriers in relation to poor signage and reception for services. In addition health workers demonstrated paternalistic attitudes as well as lack of knowledge about adolescent sexual and reproductive health services. In some cases, health workers discouraged young people from using services such as condoms and family planning methods. Lack of confidentiality and privacy were also noted to be common challenges for the young people involved. Intervention strategies that focus on changing health workers' mind-set in relation to adolescent sexual and reproductive health are crucial for ensuring quality provision of sexual and reproductive health services to young people. The study identified the importance of reception or signs at the health units, as this can facilitate young people's efforts in seeking sexual and reproductive health services. Likewise, improvement of health workers knowledge of existing policy and practice on sexual and reproductive health services and youth friendly services is much needed.
Mchome, Zaina; Richards, Esther; Nnko, Soori; Dusabe, John; Mapella, Elizabeth; Obasi, Angela
Unwelcoming behaviours and judgemental attitudes have long been recognised as a barrier to young people's access to reproductive health services. Over the last decade youth friendly reproductive health services have been promoted and implemented world-wide. However, long term evidence of the impact of these programmes is lacking. We report the results of a large mystery client evaluation of adolescent sexual and reproductive health services in Tanzania, a country that has had a long established youth friendly policy. Forty-eight visits made to thirty-three health facilities were conducted by twelve young people (six in each region) trained to perform three different scripted scenarios (i.e., condom request, information on sexually transmitted infections and family planning). The study revealed barriers in relation to poor signage and reception for services. In addition health workers demonstrated paternalistic attitudes as well as lack of knowledge about adolescent sexual and reproductive health services. In some cases, health workers discouraged young people from using services such as condoms and family planning methods. Lack of confidentiality and privacy were also noted to be common challenges for the young people involved. Intervention strategies that focus on changing health workers' mind-set in relation to adolescent sexual and reproductive health are crucial for ensuring quality provision of sexual and reproductive health services to young people. The study identified the importance of reception or signs at the health units, as this can facilitate young people's efforts in seeking sexual and reproductive health services. Likewise, improvement of health workers knowledge of existing policy and practice on sexual and reproductive health services and youth friendly services is much needed.
The purpose of this Service Action Plan is to announce, as well as provide, a high-level outline of a new Departmental process for the adoption and retirement of information technology standards. This process supports the implementation of a Department of Energy (DOE) Information Architecture. This plan was prepared with the Department of Energy information technology standards customers and stakeholders in mind. The process described in this plan will be serviced primarily by staff from the Office of the Deputy Assistant Secretary for Information Management with assistance from designated program and site Information Technology Standards Points of Contact. We welcome any comments regarding this new Departmental process and encourage the proposal of information technology standards for adoption or retirement.
The purpose of this Service Action Plan is to announce, as well as provide, a high-level outline of a new Departmental process for the adoption and retirement of information technology standards. This process supports the implementation of a Department of Energy (DOE) Information Architecture. This plan was prepared with the Department of Energy information technology standards customers and stakeholders in mind. The process described in this plan will be serviced primarily by staff from the Office of the Deputy Assistant Secretary for Information Management with assistance from designated program and site Information Technology Standards Points of Contact. We welcome any comments regarding this new Departmental process and encourage the proposal of information technology standards for adoption or retirement.
... No: 2012-25192] DEPARTMENT OF HEALTH AND HUMAN SERVICES Health Resources and Services Administration... Resources and Services Administration (HRSA), Parklawn Building (and via audio conference call), 5600... Service, Health Resources and Services Administration, Parklawn Building, Room 13-64, 5600 Fishers...
Castelo, Rui Miguel André
Mestrado em Gestão de Empresas/MOO This business plan describes all the steps and needs to build a health club in Faro. The fitness industry worldwide has showed a growing trend that in Portugal has been presented with a growing rate of 7,5% (Correia, 2006). The market penetration rate is of 5,7%, which represents 3350 potencial clients in Faro, being at the moment distributed by the 12 existing competitors, 2850 persons. The questionnaire showed that people go to the gym to ge...
Fajardo, Laurie L; Hurley, James P; Brown, Bruce P; Summers, Robert W; McDaniel, R Donald
The authors describe the University of Iowa Department of Radiology's business planning process to initiate a new service in computed tomographic colonography (CTC). Also known as virtual colonoscopy, CTC is a noninvasive technology that offers less risk, and potentially similar sensitivity and specificity, than conventional optical colonoscopy (OC). Although not currently covered by all insurance payers, about a year ago, the Centers for Medicare and Medicaid Services instituted temporary Current Procedural Terminology codes (Category III) for CTC. In locales where the procedure is not covered by insurers, it is likely to be sought by patients willing to pay out of pocket to undergo noninvasive cancer screening as an alternative to OC. Thus, CTC could become the preferred method of colon cancer surveillance by insurance providers in the near future. In developing the business plan, the authors reviewed pertinent scientific and clinical data to evaluate the need for and efficacy of CTC. Local market data were used to estimate patient and procedure volumes and utilization. The authors modeled financial expectations with respect to return on investment on the basis of recently reported models specific to CTC, resource requirements, and the operational impact of the new service on existing hospital and departmental clinical functions. Because there are few local providers of CTC in the authors' region, the business plan also included a publicity campaign and plan to market the new service, stimulate general public interest early, and differentiate the program as a leader in applying this unique new technology to promote cancer screening. Finally, the planning committee acknowledged and accommodated needs specific to the missions of an academic medical center with respect to research and education in designing the new service.
Full Text Available In information era, Geographical Information Systems (GIS are more and more accessible for general application and consequently gaining in importance. GIS information system enables storing and analyzing data, but it differs from other information systems as the data are linked to location. This enables presentation of data in map form. Therefore, the application of GIS is possible also in the field of library services,either for analysis of current services or for planning current or future services. By applying GIS, demographical data can be added to geographical data, which can result in better analysis or planning. In the paper the possibility of GIS application in the field of librarianship is presented, especially acquisition and use of publicly accessible geographical and demographical data. The majority of the needed data already exists,one only needs to find and use them properly. When using the already existing data we contribute to cost effectiveness and to the improvement of efficiency.
... 41 Public Contracts and Property Management 2 2010-07-01 2010-07-01 true Public Health Service... AND COMPLEXES 5.3-Federal Employee Health Services § 101-5.307 Public Health Service. (a) The only authorized contact point for assistance of and consultation with the Public Health Service is the...
Volpato, Luciana Fernandes; Meneghim, Marcelo de Castro; Pereira, Antonio Carlos; Ambrosano, Gláucia Maria Bovi
Quality is an indispensible requirement in the health field, and its pursuit is necessary in order to meet demands by a population that is aware of its rights, as part of the essence of good work relations, and to decrease technological costs. Quality thus involves all parties to the process (users and professionals), and is no longer merely an attribute of the health service. This study aimed to verify the possibility of quality planning in the Family Health Units, using Quality Function Deployment (QFD). QFD plans quality according to user satisfaction, involving staff professionals and identifying new approaches to improve work processes. Development of the array, called the House of Quality, is this method's most important characteristics. The results show a similarity between the quality demanded by users and the quality planned by professionals. The current study showed that QFD is an efficient tool for quality planning in public health services.
Jocelyne Kane Berman
Full Text Available Despite their numerical superiority women do not occupy positions o f power and authority in the health services generally. This is perceived as being due to a variety of factors which prevent women from realising their ful l potential as managers. In other parts of the world, as well as in South Africa, middle class white males have dominated health services, since medicine became a form al science, usurping the traditional role of women healers. Some research indicates that women are inclined to practice “feminine " management styles. It is suggested that the femine I masculine dichotomy is artificial and that qualities which ensure effective management should not be regarded as genderlinked. Leaders in the health services should strive for interdisciplinary, mixed-gender education and training at all levels. Identification and development of management potential in women health-care professionals, role-modelling and sponsor-mentor relationships should be encouraged to allow women to acquire the full range of management skills and to achieve positions of power and authority in the health services.
Van Hoof, Thomas J; Sherwin, Tierney E; Baggish, Rosemary C; Tacy, Peter B; Meehan, Thomas P
Private schools educate a significant percentage of US children and adolescents. Private schools, particularly where students reside during the academic year, assume responsibility for the health and well-being of their students. Children and adolescents experience mental health problems at a predictable rate, and private schools need a mechanism for addressing their students' mental health needs. Understanding that need requires data to guide the services and programs a school may put in place. Having data helps inform those services, and comparative data from other schools provides feedback and perspective. This project surveyed type and frequency of mental health problems experienced by students who received a formal evaluation at 11 private schools in Connecticut during academic year 2001-2002.
Roberts, Patrick; Molyneux, Helen
Whereas major incident planning is very well established within National Health Service (NHS) organisations in the UK, business continuity management (BCM) planning, in many cases, is a relatively new activity; however, a combination of factors including the emergence of H1N1 influenza, has led to growing interest in the subject. This paper draws on both the personal experience of the authors and published research in relevant fields to make a number of specific recommendations about the effective implementation of BCM within NHS organisations. These include the need to define the BCM project properly; conduct a thorough business impact analysis considering 'back office' as well as clinical activities; define suitable command and control arrangements with clear delegated authority; and support plan development with appropriate training.
Barrêto, Anne Jaquelyne Roque; de Sá, Lenilde Duarte; Nogueira, Jordana de Almeida; Palha, Pedro Fredemir; Pinheiro, Patrícia Geórgia de Oliveira Diniz; de Farias, Nilma Maria Porto; Rodrigues, Débora Cezar de Souza; Villa, Tereza Cristina Scatena
The scope of this study was to analyze the discourse of managers regarding the relationship between the organization of the health services and tuberculosis care management in a city in the metropolitan region of João Pessoa, State of Pernambuco. Using qualitative research in the analytical field of the French line of Discourse Analysis, 16 health workers who worked as members of the management teams took part in the study. The transcribed testimonials were organized using Atlas.ti version 6.0 software. After detailed reading of the empirical material, an attempt was made to identify the paraphrasic, polyssemic and metaphoric processes in the discourses, which enabled identification of the following discourse formation: Organization of the health services and the relation with TB care management: theory and practice. In the discourse of the managers the fragmentation of the actions of control of tuberculosis, the lack of articulation between the services and sectors, the compliance of the specific activities for TB, as well as the lack of strategic planning for management of care of the disease are clearly revealed. In this respect, for the organization of the health services to be effective, it is necessary that tuberculosis be considered a priority and acknowledged as a social problem in the management agenda.
The purpose of this study was to discuss the implementation of nutritional education in public health services from the perspective of health professionals (physicians and nurses) working in them. The study was conducted in the Municipality of Campinas, São Paulo State, Brazil, from October 1993 to July 1995, using action-based research methodology. The results describe the construction of nutritional knowledge in training and professional institutions; behavior towards food-related problems ...
... Forest Service Public Meetings on the Development of the Forest Service Land Management Planning Rule... to developing a new Forest Service Land Management Planning Rule (planning rule) through a... roundtables. Summaries of each session will be produced and posted on the planning rule Web site as part of...
Yarger, Jennifer; Decker, Martha J; Campa, Mary I; Brindis, Claire D
The purpose of this study was to compare awareness and use of family planning services by rural and urban program site among a sample of adolescent women before participation in the federal Personal Responsibility Education Program in California. We conducted a secondary analysis of survey data collected from youth before participation in California's Personal Responsibility Education Program. Bivariate and multivariate analyses were conducted for a sample of 4,614 females ages 14-18 years to compare awareness and use of family planning services between participants at rural and urban program sites, controlling for the program setting and participant demographic, sexual, and reproductive characteristics. Overall, 61% of participants had heard of a family planning provider in their community, and 24% had visited a family planning provider. Awareness and use of family planning services were lower among rural participants than urban participants. After adjusting for the program setting and participant characteristics, rural participants were less likely to know about a family planning provider in their community (odds ratio, .64; 95% confidence interval, .50-.81) or receive family planning services (odds ratio, .76; 95% confidence interval, .58-.99) than urban participants. Findings suggest that adolescents in rural areas face greater barriers to accessing family planning services than adolescents in urban areas. Targeted efforts to increase awareness and use of family planning services among adolescents in rural areas and among other underserved populations are needed. Copyright © 2016 Society for Adolescent Health and Medicine. Published by Elsevier Inc. All rights reserved.
Sukumar, G M; Rawat, S; V H H, S; Gururaj, G
Non-communicable diseases (NCDs) and psychological hazards are increasingly observed in industries, necessitating the need to strengthen industrial health systems to control the same. District level data on level of functioning of industrial health systems and services with special focus on systems available for mental health care is lacking in India. This information is vital to plan need-based interventions for system strengthening. To assess the status of functioning of industrial health systems and services in Kolar district, India, with special focus on systems and services available for mental health care. This cross-sectional study was undertaken between October and December 2014 on a stratified random sample of 69 industries located in Kolar, which were stratified proportionately by their hazardous nature. Interview and observation checklist were used to assess and classify functioning of industrial health systems and services including those available for mental health care. Occupational safety and health (OSH) policy was present in 56% and health insurance in 39% of the 69 industries assessed. Pre-placement and periodical medical examination were conducted in 23% of industries. Health systems and services in hazardous industries were functioning at less than 50% level of functioning. Health systems and services for mental health care were non-existent. There is a need in Kolar district, India, to integrate the mental health components within existing industrial health systems, as per policy directives to implement setting based approaches in mental health programs.
Full Text Available Background: Non-communicable diseases (NCDs and psychological hazards are increasingly observed in industries, necessitating the need to strengthen industrial health systems to control the same. District level data on level of functioning of industrial health systems and services with special focus on systems available for mental health care is lacking in India. This information is vital to plan need-based interventions for system strengthening. Objective: To assess the status of functioning of industrial health systems and services in Kolar district, India, with special focus on systems and services available for mental health care. Methods: This cross-sectional study was undertaken between October and December 2014 on a stratified random sample of 69 industries located in Kolar, which were stratified proportionately by their hazardous nature. Interview and observation checklist were used to assess and classify functioning of industrial health systems and services including those available for mental health care. Results: Occupational safety and health (OSH policy was present in 56% and health insurance in 39% of the 69 industries assessed. Pre-placement and periodical medical examination were conducted in 23% of industries. Health systems and services in hazardous industries were functioning at less than 50% level of functioning. Health systems and services for mental health care were non-existent. Conclusion: There is a need in Kolar district, India, to integrate the mental health components within existing industrial health systems, as per policy directives to implement setting based approaches in mental health programs.
Johnston, Beverly; Ligiero, Daniela; DeSilva, Shyami; Medley, Amy; Nightingale, Vienna; Sripipatana, Tabitha; Bachanas, Pamela; Abutu, Andrew; Brewinski-Isaacs, Margaret; Bathily, Fatoumata; Grillo, Michael; Bertz, Lilly; Mani, Nithya
The integration of health programs, including HIV and voluntary family planning, is a priority for US government foreign assistance. One critical component of family planning and HIV integration that has significant positive health outcomes is ensuring that all women living with HIV have access to both a full range of contraceptives and safe pregnancy counseling. This article outlines the US government global health strategy to meet the family planning needs of women living with HIV based on three key principles: a focus on reproductive rights through voluntarism and informed choice, quality service provision through evidence-based programming, and development of partnerships.
El Taguri A
Full Text Available Health services have the functions to define community health problems, to identify unmet needs and survey the resources to meet them, to establish SMART objectives, and to project administrative actions to accomplish the purpose of proposed action programs. For maximum efficacy, health systems should rely on newer approaches of management as management-by-objectives, risk-management, and performance management with full and equal participation from professionals and consumers. The public should be well informed about their needs and what is expected from them to improve their health. Inefficient use of budget allocated to health services should be prevented by tools like performance management and clinical governance. Data processed to information and intelligence is needed to deal with changing disease patterns and to encourage policies that could manage with the complex feedback system of health. e-health solutions should be instituted to increase effectiveness and improve efficiency and informing human resources and populations. Suitable legislations should be introduced including those that ensure coordination between different sectors. Competent workforce should be given the opportunity to receive lifetime appropriate adequate training. External continuous evaluation using appropriate indicators is vital. Actions should be done both inside and outside the health sector to monitor changes and overcome constraints.
Singh, M; Paul, V K
India has an excellent infrastructural layout for the delivery of MCH services in the community through a network of subcenters, primary health centers, community health centers, district hospitals, state medical college hospitals, and other hospitals in the public and private sectors. However, the health pyramid does not function effectively because of limited resources, communication delays, a lack of commitment on the part of health professionals, and, above all, a lack of managerial skills, supervision, and political will. The allocation of financial resources for the delivery of health care continues to be meager. Nevertheless, in spite of obvious constraints, the country has made laudable progress in reducing post-neonatal mortality in recent years. Indeed, the focus has shifted to the young infants and the perinates. Under the CSSM program, a massive expansion of MCH services has occurred at the sub-district and the district levels. The RCH program, to be launched shortly, aims at effective utilization of these facilities to ensure delivery of integrated services of assured quality through decentralized planning. Simultaneously, as a result of the ongoing economic liberalization, the MCH care in the private sector will also expand rapidly. Indeed, India is on the threshold of an extraordinary improvement in the status of its neonatal-perinatal health.
Icks, A; Chernyak, N; Bestehorn, K; Brüggenjürgen, B; Bruns, J; Damm, O; Dintsios, C-M; Dreinhöfer, K; Gandjour, A; Gerber, A; Greiner, W; Hermanek, P; Hessel, F; Heymann, R; Huppertz, E; Jacke, C; Kächele, H; Kilian, R; Klingenberger, D; Kolominsky-Rabas, P; Krämer, H; Krauth, C; Lüngen, M; Neumann, T; Porzsolt, F; Prenzler, A; Pueschner, F; Riedel, R; Rüther, A; Salize, H J; Scharnetzky, E; Schwerd, W; Selbmann, H-K; Siebert, H; Stengel, D; Stock, S; Völler, H; Wasem, J; Schrappe, M
On August 30, 2010, the German Network for Health Services Research [Deutsches Netzwerk Versorgungsforschung e. V. (DNVF e. V.)] approved the Memorandum III "Methods for Health Services Research", supported by the member societies mentioned as authors and published in this Journal [Gesundheitswesen 2010; 72: 739-748]. The present paper focuses on methodological issues of economic evaluation of health care technologies. It complements the Memorandum III "Methods for Health Services Research", part 2. First, general methodological principles of the economic evaluations of health care technologies are outlined. In order to adequately reflect costs and outcomes of health care interventions in the routine health care, data from different sources are required (e. g., comparative efficacy or effectiveness studies, registers, administrative data, etc.). Therefore, various data sources, which might be used for economic evaluations, are presented, and their strengths and limitations are stated. Finally, the need for methodological advancement with regard to data collection and analysis and issues pertaining to communication and dissemination of results of health economic evaluations are discussed. © Georg Thieme Verlag KG Stuttgart · New York.
... service needs? 641.330 Section 641.330 Employees' Benefits EMPLOYMENT AND TRAINING ADMINISTRATION... Employment Services Coordination Plan § 641.330 How should the State Plan reflect community service needs? The Governor must ensure that the State Plan identifies the types of community services that...
Hughes, D C; Brindis, C; Halfon, N; Newacheck, P W
Increasingly, the public and private sectors are turning to "service integration" efforts to reduce, if not eliminate, barriers to needed care created by categorical programs. In 1991, the Robert Wood Johnson Foundation established a new national demonstration project, called the Child Health Initiative, intended to test the feasibility of developing mechanisms at the community level to coordinate the delivery of health services and to pay for those services through a flexible pool of previously categorical funds. This article presents the findings of an independent evaluation of the Child Health Initiative. The evaluation utilized a combination of qualitative methods to assess and describe the experiences of the communities as they developed and implemented integrated health services. It used a repeated measures design involving two site visits and interim telephone interviews, as well as review of documents. Overall, the demonstration project achieved mixed success. Both care coordination and the production of community health report cards were found to be achievable within the relatively short life of the foundation grant. However, many sites experienced significant delays in the production of report cards and implementing care coordination plans because the sites largely did not benefit from the successful models already in existence. Little clear progress was made in implementing the decategorization component of the project. Sites experienced difficulties due to lack of previous experience with this new undertaking, the inability to secure active cooperation from local, state, and federal agencies, the relatively short duration of the project, and other factors. A number of lessons were learned from this project that may be useful in future decategorization experiments, including (1) a clear understanding of the concept and its applications among all parties is essential, (2) high-level political commitments to the effort are needed between all levels of
National Heart and Lung Inst. (DHEW/PHS), Bethesda, MD.
The Hemophilia Health Education Planning Project was designed to (1) create a set of tools useful in hemophilia planning and education, and (2) create a planning model for other diseases with similar factors. The project used the game-simulations technique which was felt to be particularly applicable to hemophilia health problems, since as a…
Villalba, E.; Casas, I.; Abadie, F.
Objectives: The deployment and adoption of Integrated Personal Health and Care Services in Europe has been slow and fragmented. There have been many initiatives and projects of this kind in different European regions, many of which have not gone beyond the pilot stage. We investigated the necessa...... of Integrated Personal Health and Care Services in European regions has increased. Further research will reveal the weight of each facilitator and which combinations of facilitators lead to rapid adoption.......Objectives: The deployment and adoption of Integrated Personal Health and Care Services in Europe has been slow and fragmented. There have been many initiatives and projects of this kind in different European regions, many of which have not gone beyond the pilot stage. We investigated the necessary...... conditions for mainstreaming these services into care provision. Methods: We conducted a qualitative analysis of 27 Telehealth, Telecare and Integrated Personal Health System projects, implemented across 20 regions in eight European countries. The analysis was based on Suter’s ten key principles...
Full Text Available The death of the English National Health Service (NHS has been pronounced many times over the years, but the time and cause of death and the murder weapon remains to be fully established. This article reviews some of these claims, and asks for clearer criteria and evidence to be presented.
van 't Klooster, J.W.J.R.
This thesis describes a method to offer personalised healthcare. It is motivated by a desire for more efficient healthcare, as population ages and care demand and costs increase. Developing and testing individually tailored health services using ICT fits in this motivation, as it leads to more
Full Text Available We present a web service based tool for the planning of atmospheric research flights. The tool provides online access to horizontal maps and vertical cross-sections of numerical weather prediction data and in particular allows the interactive design of a flight route in direct relation to the predictions. It thereby fills a crucial gap in the set of currently available tools for using data from numerical atmospheric models for research flight planning. A distinct feature of the tool is its lightweight, web service based architecture, requiring only commodity hardware and a basic Internet connection for deployment. Access to visualisations of prediction data is achieved by using an extended version of the Open Geospatial Consortium Web Map Service (WMS standard, a technology that has gained increased attention in meteorology in recent years. With the WMS approach, we avoid the transfer of large forecast model output datasets while enabling on-demand generated visualisations of the predictions at campaign sites with limited Internet bandwidth. Usage of the Web Map Service standard also enables access to third-party sources of georeferenced data. We have implemented the software using the open-source programming language Python. In the present article, we describe the architecture of the tool. As an example application, we discuss a case study research flight planned for the scenario of the 2010 Eyjafjalla volcano eruption. Usage and implementation details are provided as Supplement.
U.S. Department of Health & Human Services — The National Mental Health Services Survey (N-MHSS) is designed to collect information from all specialty mental health facilities in the United States, both public...
Olivares, V Ed
During the last months of 2000, administrators at the Mercy San Juan Medical Center in Carmichael, Calif., convened a steering committee to plan the Mercy Center for Breast Health. The Steering Committee was composed of the director of ancillary and support services, the oncology clinical nurse specialist, the RN manager of the oncology nursing unit, the RN surgery center manager, and me, the manager of imaging services. The committee was responsible for creating a new business with five specific objectives: to position the Center as a comprehensive diagnostic and resource center for women; to generate physician referrals to the Breast Center through various vehicles; to create awareness of the Breast Center's capabilities among area radiologists; to create awareness of the Breast Center among employees of six sister facilities; to create "brand awareness" for the Mercy Center for Breast Health among referring physicians and patients who could use competing centers in the area. The Steering Committee's charter was to design a center with a feminine touch and ambience and to provide a "one-stop shopping" experience for patients. A major component of the Breast Center is the Dianne Haselwood Resource Center, which provides patients with educational support and information. The Steering Committee brought its diverse experience and interests to bear on arranging for equipment acquisition, information and clerical systems, staffing, clinic office design, patient care and marketing. Planning the Mercy Center for Breast Health has been a positive challenge that brought together many elements of the organization and people from different departments and specialties to create a new business venture. Our charge now is to grow and to live up to our vision of offering complete breast diagnostic, education and support services in one location.
LaFleur, E K; Taylor, S L
More than 75% of the female respondents in this study would choose a women's health center (WHC) over a standard health facility. Women who worked outside the home perceived a greater WHC need. And almost all respondents were interested in communications from the center via a quarterly newsletter. Significant test results related to age, income, education, and work status as segmentation variables, offering WHC's an opportunity to target their patients with specialized services such as cosmetic surgery, infertility treatment, breast imaging, etc. If enough resources are allocated, a WHC can design itself to attract highly lucrative patients. Little difference was found in the opinions of women regarding the need for a WHC or the core services desired, but the specific service mix decision must be carefully considered when designing a WHC.
Levy, J S
The author introduces the concept of service guarantees for application in health care and differentiates between explicit, implicit, and conditional vs. unconditional types of guarantees. An example of an unconditional guarantee of satisfaction is provided by the hospitality industry. Firms conveying an implicit guarantee are those with outstanding reputations for products such as luxury automobiles, or ultimate customer service, like Nordstrom. Federal Express and Domino's Pizza offer explicit guarantees of on-time delivery. Taking this concept into efforts to improve health care delivery involves a number of caveats. Customers invited to use exceptional service cards may use these to record either satisfaction or dissatisfaction. The cards need to provide enough specific information about issues so that "immediate action could be taken to improve processes." Front-line employees should be empowered to respond to complaints in a meaningful way to resolve the problem before the client leaves the premises.
Lusi Herawati Sunyoto Usman Mark Zuidgeest
as indicators. Flowmap tool is used to analyze catchment area of each health facility using different transport modes choice:becak and public transport for poor group and motorcycle and car for non-poor group with different travel time within 30, 60 and more than 60 minutes. It is concluded that there was an accessibility difference between poor and non-poor group. The accessibility to the health facilities of poor group was lower than non-poor group. This condition occurred because the government policy of equitable access to health service facility did not pay attention to accessibility of poor group.
Oborn, Eivor; Barrett, Michael; Darzi, Ara
Robots have long captured our imagination and are being used increasingly in health care. In this paper we summarize, organize and criticize the health care robotics literature and highlight how the social and technical elements of robots iteratively influence and redefine each other. We suggest the need for increased emphasis on sociological dimensions of using robots, recognizing how social and work relations are restructured during changes in practice. Further, we propose the usefulness of a 'service logic' in providing insight as to how robots can influence health care innovation. The Royal Society of Medicine Press Ltd 2011.
Monteiro, Camila Nascimento; Beenackers, Mariëlle A; Goldbaum, Moisés; de Azevedo Barros, Marilisa Berti; Gianini, Reinaldo José; Cesar, Chester Luiz Galvão; Mackenbach, Johan P
Access to, and use of, dental health services in Brazil have improved since 2003. The increase of private health care plans and the implementation of the "Smiling Brazil" Program, the largest public oral health care program in the world, could have influenced this increase in access. However, we do not yet know if inequalities in the use of dental health services persist after the improvement in access. The aims of this study are to analyze socioeconomic differences for dental health service use between 2003 and 2008 in São Paulo and to examine changes in these associations since the implementation of the Smiling Brazil program in 2003. Data was obtained via two household health surveys (ISA-Capital 2003 and ISA-Capital 2008) which investigated living conditions, lifestyle, health status and use of health care services. Logistic regression was used to analyze associations between socioeconomic factors and dental services use. Additionally, trends from 2003 to 2008 regarding socioeconomic characteristics and dental health service use were explored. Overall, dental health service use increased between 2003 and 2008 and was at both time points more common among those who had higher income, better education, better housing conditions, private health care plans and were Caucasian. Inequalities in use of dental health care did not decrease over time. Among the reasons for not seeking dental care, not having teeth and financial difficulty were more common in lower socioeconomic groups, while thinking it was unnecessary was more common in higher socioeconomic groups. The Brazilian oral health policy is still in a period of expansion and seems to have contributed slightly to increased dental health service use, but has not influenced socioeconomic inequalities in the use of these services. Acquiring deeper knowledge about inequalities in dental health service use will contribute to better understanding of potential barriers to reducing them.
Chillida, Manuela de Santana Pi; Cocco, Maria Inês Monteiro
In the last two decades, service outsourcing has reduced companies' costs by the rationalization of their actions and the exploration of precarious work relations. This research aimed to outline the profile of outsourced workers in the cleaning service of a university hospital, identify their points of view about the health-illness process and future plans. This is a descriptive study from a quantitative approach, involving a random sample with 50 cleaning workers. Most of them started to work early, 74% were women and education level was low. In 36% of the cases, physicians diagnosed some kind of illness. In the analyzed period, 84% of the interviewees had realized medical consultations, resulting in an average of 3.6 consultations per worker, 56% of which involved general clinicians. Data analysis allowed for the identification of these professionals' perspectives in relation to the health/illness process and their future.
SUN Peng; LIU Zhi-ping; QIU Hong; YANG Da-cheng
In CDMA network planning, it's important to understand the characteristics of multi-services. A novel method for analyzing the coverage of mixed voice and packet data traffics is presented in this paper. Based upon GIS and Monte-Carlo simulation method, this method can provide more precise but less time-consuming analysis result than before.A practical analysis case using real geographic information and network parameters is applied to verify its performance and find some useful solutions. Simulation results show that this coverage analysis method can provide helpful solution for the radio networks planning.
Crettenden, Ian; Poz, Mario Dal; Buchan, James
This editorial introduces the 'Right time, Right place: improving access to health service through effective retention and distribution of health workers' thematic series. This series draws from studies in a range of countries and provides new insights into what can be done to improve access to health through more effective human resources policies, planning and management. The primary focus is on health workforce distribution and retention.
Msovela, Judith; Tengia-Kessy, Anna
Men as the main decision makers in most of African families have an important role to play towards acceptance of family planning methods. This study sought to identify strategies used to engage men in family planning services and determine the extent to which men in Kibaha district in Tanzania accept these interventions. We conducted a cross sectional study using both quantitative and qualitative techniques. We used a questionnaire to interview a random sample of 365 of currently married or cohabiting men who had at least one child under the age of five years. We further conducted in-depth interviews with health workers involved in delivering reproductive health services as well as community dispensers of family planning commodities. Descriptive analysis was used to determine the extent to which men were engaged in family planning services. The data from the indepth interviews were analysed manually according to the predetermined themes, guided by the grounded theory to identify the existing strategies used to encourage male involvement in family planning services. According to the key informants, strategies that are used to encourage men to engage in family planning services include invitations through their spouses, either verbally or by using partner notification cards, incorporating family planning messages during monthly meetings and community outreach reproductive health programs. Of 365 men responding to the questionnaire, only 31 (8.4%) said they were invited to accompany their spouses to family planning clinics. Among them, 71% (22/31) visited family planning clinics. A third (32%) of the respondents had heard of community health meetings and only 20.7% of them attended these meetings. More than a third (12/34) of men who attended these meeting asserted that family planning messages targeting men featured in the agenda and subsequently half of them visited health facilities for family planning services. Existing strategies such as invitations to clinics
Full Text Available The state policy in the health care area must take into account the complexity and specificity of the domain. Health means not only “to treat”, but also “to prevent” and “to recover and rehabilitate the individual physically”. Regardless of the adopted health insurance system, the health system is facing a big problem and this is the insufficient funds necessary to function properly. The underfunding may have various causes, from a wrong health policy, based on “treating” instead of “preventing”, by the misuse of funds. This papers intended to formulate assumptions that underpin the research I am conducting within the Doctoral Research Program held at the Valahia University of Targoviste, which aims at using the management control in increasing the health services performance. The application of the accounting and management control methods in determining health costs can be a beginning to streamline the system. This is also a result of the fact that health care is a public service with specific characteristics: it can not be subject only to market requirements but at the same time he must undergo an administrative savings, representing a typical case of market failure. The increased cost of treatment, as well as the decline in their quality can be determined by the discrepancy between the funding and payment mechanisms. Different payment systems currently available do nothing but perpetuate the shortcomings in the system. Switching to the introduction of cost and budgets by cost centers or object (if solved can be a step forward for a better management of resources. In this context, we consider as a necessity to be imposed the cost analysis on responsibility centers, the definition of the cost object and cost center identification and determination of direct costs and those indirect services to choose the basis for the allocation of cost centers and the determination of each actual cost per diagnosis.
Velimirovic, H; Velimirovic, B
There is considerable interest at this time in the possible integration of traditional birth attendants (TBAs) within the health services of a country, particularly in the field of maternal and child health care and family planning. The objectives are better utilization of local human resources as fundamental to public health care, and actions have been taken to improve the utilization, training and supervision of TBAs in these broader fields. Generally, the traditional midwife advises on prenatal care, assists during delivery and gives postnatal care. Several Expert Committees of the World Health Organization (WHO) referred to maternity care in connection with the training of auxiliary health workers, including auxiliary midwives, as early as 1952 and 1955. In many countries this interest stimulated research in order to identify feasible models contributing to the extension of health care through the training of auxiliary and traditional midwives. A problem is the mode of the selection of TBAs as participants in training courses. Most programs provide for group training, but this is not feasible in rural and remote areas with low population density. The acceptance of TBAs is not universal in all developign countries; some governments totally reject the plan. In the absence of evaluation of trained TBAs, doubts have been raised about the effectiveness of the trained TBA. Their role may be limited, transitional at best.
Farmanova, Elina; Bonneville, Luc; Bouchard, Louise
The availability of health services in French is not only weak but also inexistent in some regions in Canada. As a result, estimated 78% of more than a million of Francophones living in a minority situation in Canada experience difficulties accessing health care in French. To promote the delivery of health services in French, publicly funded organizations are encouraged to take measures to ensure that French-language services are clearly visible, available, easily accessible, and equivalent to the quality of services offered in English. This study examines the reorganization and management strategies taken by health care organizations in Ontario that provide health services in French. Review and analysis of designation plans of a sample of health care organizations. Few health care organizations providing services in French have concrete strategies to guarantee availability, visibility, and accessibility of French-language services. Implementation of the active offer of French-language services is likely to be difficult and slow. The Ontario government must strengthen collaboration with health care organizations, Francophone communities, and other key actors participating in the designation process to help health care organizations build capacities for the effective offer of French-language services. Copyright © 2017 John Wiley & Sons, Ltd.
Krieger, G.R.; Balge, M.Z.
Occupational/Public Health Services are becoming increasingly required in projects that involve the extended presence of expatriates in remote underdeveloped areas of the world. These ``expats`` are defined as individuals living and working in the environment who are not indigenous to the area. Under this definition, workers who are resistant to a ``local`` strain of malaria and then relocate to another geographic within the same country can also be considered as ``biologic expatriates`` since their resistance profile for certain tropical diseases is not reflective of their new environment. Unlike a major infrastructure project in the industrialized world, project planners in remote areas of the developing world should be expected to make significant long term medical and environmental commitments. US companies have extensive experience in the business of large-scale development projects, e.g. oil and gas pipelines and well field development; however, these projects represent major long-term in-country commitments with potentially large labor forces and substantial and sustained impacts on local health and safety resources. The initial structuring of health and safety programs will, therefore, have long-term ramifications on the project both during construction and ``routine`` operations since the multi-national companies are increasingly expected to develop and maintain self-sustaining health, safety and environmental programs.
Jaime Alberto Guzmán Luna
Full Text Available This article proposes applying semantic web and artificial intelligence planning techniques to a web services composition model dealing with problems of ambiguity in web service description and handling incomplete web information. The model uses an OWL-S services and implements a planning technique which handles open world semantics in its reasoning process to resolve these problems. This resulted in a web services composition system incorporating a module for interpreting OWL-S services and converting them into a planning problem in PDDL (a planning module handling incomplete information and an execution service module concurrently interacting with the planner for executing each composition plan service.
Full Text Available Introduction: In 2007, a substantial reform changed the administrative boundaries of the Danish health care system and introduced health care agreements to be signed between municipal and regional authorities. To assess the health care agreements as a tool for coordinating health and social services, a survey was conducted before (2005–2006 and after the reform (2011.Theory and methods: The study was designed on the basis of a modified version of Alter and Hage's framework for conceptualising coordination. Both surveys addressed all municipal level units (n = 271/98 and a random sample of general practitioners (n = 700/853.Results: The health care agreements were considered more useful for coordinating care than the previous health plans. The power relationship between the regional and municipal authorities in drawing up the agreements was described as more equal. Familiarity with the agreements among general practitioners was higher, as was the perceived influence of the health care agreements on their work.Discussion: Health care agreements with specific content and with regular follow-up and systematic mechanisms for organising feedback between collaborative partners exemplify a useful tool for the coordination of health and social services.Conclusion: There are substantial improvements with the new health agreements in terms of formalising a better coordination of the health care system.
Full Text Available Online route planning services compute routes from any given location to a desired destination address. Unlike offline implementations, they do so in a traffic-aware fashion by taking into consideration up-to-date map data and real-time traffic information. In return, users have to provide precise location information about a route’s endpoints to a not necessarily trusted service provider. As suchlike leakage of personal information threatens a user’s privacy and anonymity, this paper presents PrOSPR, a comprehensive approach for using current online route planning services in a privacy-preserving way, and introduces the concept of k-immune route requests to avert inference attacks based on restricted space information. Using a map-based approach for creating cloaked regions for the start and destination addresses, our solution queries the online service for routes between subsets of points from these regions. This, however, might result in the returned path deviating from the optimal route. By means of empirical evaluation on a real road network, we demonstrate the feasibility of our approach regarding quality of service and communication overhead.
Gudes, Ori; Kendall, Elizabeth; Yigitcanlar, Tan; Pathak, Virendra; Baum, Scott
The field of collaborative health planning faces significant challenges created by the narrow focus of the available information, the absence of a framework to organise that information and the lack of systems to make information accessible and guide decision-making. These challenges have been magnified by the rise of the 'healthy communities movement', resulting in more frequent calls for localised, collaborative and evidence-driven health related decision-making. This paper discusses the role of decision support systems as a mechanism to facilitate collaborative health decision-making. The paper presents a potential information management framework to underpin a health decision support system and describes the participatory process that is currently being used to create an online tool for health planners using geographic information systems. The need for a comprehensive information management framework to guide the process of planning for healthy communities has been emphasised. The paper also underlines the critical importance of the proposed framework not only in forcing planners to engage with the entire range of health determinants, but also in providing sufficient flexibility to allow exploration of the local setting-based determinants of health.
Migdole, Scott; Robbins, Judith P
The role of preadjudicated juvenile detention centers (JDCs) in treating children and adolescents with mental health needs has continued to receive national attention. Legal actions mandating improved health care services over the past decade, coupled with a national focus on detainees' mental health needs, have led to the increased presence of mental health professionals in JDCs. In this context, we must build on the current "call to action" and develop innovative blueprints for the provision of mental health services for detained youth. Although operationalizing this movement is complicated, we must be prepared to sustain its effects by developing effective communication and planning among correctional health care organizations, universities, municipalities, and other stakeholders.
Full Text Available The ecosystem services approach has been proven successful to measure the contributions of nature and greenery to human well-being. Ecosystems have an effect on quality of life, but landscapes also, as a broader concept, may contribute to people's well-being. The concept of landscape services, compared to ecosystem services, involves the social dimension of landscape and the spatial pattern resulting from both natural and human processes in the provision of benefits for human-well being. Our aim is to develop a classification for landscape services. The proposed typology of services is built on the Common International Classification of Ecosystem Services (CICES and on a critical review of existing literature on human well-being dimensions, existing ecosystem service classifications, and landscape perception. Three themes of landscape services are defined, each divided into several groups: provisioning, regulation and maintenance, cultural and social life fulfillment, with the latter focusing on health, enjoyment, and personal and social fulfillment. A special emphasis is made on cultural services, which are especially important when applied to landscape and which have received less attention.
Chen, Rui; Zhao, Yali; Du, Juan; Wu, Tao; Huang, Yafang; Guo, Aimin
To reveal the equity of health workforce distribution in urban community health service (CHS), and to provide evidence for further development of community health service in China. A community-based, cross-sectional study was conducted in China from September to December 2011. In the study, 190 CHS centers were selected from 10 provinces of China via stratified multistage cluster sampling. Human resources profiles and basic characteristics of each CHS centers were collected. Lorenz curves and Gini Coefficient were used to measure the inequality in the distribution of health workforce in community health service centers by population size and geographical area. Wilcoxon rank test for paired samples was used to analyze the differences in equity between different health indicators. On average, there were 7.37 health workers, including 3.25 doctors and 2.32 nurses per 10,000 population ratio. Significant differences were found in all indicators across the samples, while Beijing, Shandong and Zhejiang ranked the highest among these provinces. The Gini coefficients for health workers, doctors and nurses per 10,000 population ratio were 0.39, 0.44, and 0.48, respectively. The equity of doctors per 10,000 population ratio (G = 0.39) was better than that of doctors per square kilometer (G = 0.44) (P = 0.005). Among the total 6,573 health workers, 1,755(26.7%) had undergraduate degree or above, 2,722(41.4%)had junior college degree and 215(3.3%) had high school education. Significant inequity was found in the distribution of workers with undergraduate degree or above (G = 0.52), which was worse than that of health works per 10000 population (Purban CHS centers.
E-Health applications have to take the business perspective into account. This is achieved by adding a fourth layer reflecting organizational and business processes to an existing three layer model for IT-system functionality and management. This approach is used for designing a state-wide e-Health service delivery allowing for distributed responsibilities: clinical organizations act on the fourth layer and have established mutual cooperation in this state-wide approach based on collectively outsourced IT-system services. As a result, no clinical organization can take a dominant role based on operating the IT-system infrastructure. The implementation relies on a central infrastructure with extended means to guarantee service delivery: (i) established redundancy within the system architecture, (ii) actively controlled network and application availability, (iii) automated routine performance tests fulfilling regulatory requirements and (iv) hub-to-spoke and end-to-end authentication. As a result, about half of the hospitals and some practices of the state have signed-up to the services and guarantee long-term sustainability by sharing the infrastructural costs. Collaboration takes place for more than 1000 patients per month based on second opinion, online consultation and proxy services for weekend and night shifts.
Defense Advanced Research Projects Agency (DARPA) Joint Air Ground Unified Adaptive Re-planner ( JAGUAR ) program [ JAGUAR ]. For the cyber domain...loaded the Plan Repository with a 50-mission dataset adapted from the previous DARPA JAGUAR program. For space missions, we authored the OPIR mission...2013) include, by service: • Integrate Cornerstone with BAE Systems’ DARPA JAGUAR automated air mission generator and CACI’s AFRL-sponsored Air
Being one of the fastest-growing nations in the world, Vietnam is trading across the border actively and at the same time attracting multiple foreign investments. Import and export activities are occurring vigorously which leads to a huge potential for international transportation sectors, particularly for aviation industry. Hence, the ultimate goal of this thesis is to establish a development plan of air freight service for the case company – CMA CGM Logistics Vietnam (CCLOG VN). The stu...
Heredia-Martínez, Henny Luz; Artmann, Elizabeth; Porto, Silvia Marta
The article discusses the results of operationalizing Situational Strategic Planning adapted to the local level in health, considering the communicative approach and equity in a parish in Venezuela. Two innovative criteria were used: estimated health needs and analysis of the actors' potential for participation. The problems identified were compared to the corresponding article on rights in the Venezuelan Constitution. The study measured inequalities using health indicators associated with the selected problems; equity criteria were incorporated into the action proposals and communicative elements. Priority was assigned to the problem of "low case-resolving capacity in the health services network", and five critical points were selected for the action plan, which finally consisted of 6 operations and 21 actions. The article concludes that the combination of epidemiology and planning expands the situational explanation. Incorporation of the communicative approach and the equity dimension into Situational Strategic Planning allows empowering health management and helps decrease the gaps from inequality.
Conclusions The level of integration in the Finnish social welfare and healthcare system is high and seems to be increasing, especially in health centres. Within one year a client uses many kinds of inpatient services. This may at best represent a functioning system of care pathways and at worst mean overlapping work and lack of coordination. This information is of great importance to senior officers in care pathway planning.
... insurance benefits and services. Subject to § 101-4.235(d), in providing a medical, hospital, accident, or life insurance benefit, service, policy, or plan to any of its students, a recipient shall not... 41 Public Contracts and Property Management 2 2010-07-01 2010-07-01 true Health and...
... 15 Commerce and Foreign Trade 1 2010-01-01 2010-01-01 false Health and insurance benefits and... benefits and services. Subject to § 8a.235(d), in providing a medical, hospital, accident, or life insurance benefit, service, policy, or plan to any of its students, a recipient shall not discriminate...
... 28 Judicial Administration 2 2010-07-01 2010-07-01 false Health and insurance benefits and... benefits and services. Subject to § 54.235(d), in providing a medical, hospital, accident, or life insurance benefit, service, policy, or plan to any of its students, a recipient shall not discriminate...
Santiago, Catherine DeCarlo; Kataoka, Sheryl H.; Forness, Steven R.; Miranda, Jeanne
This article presents a collaborative study conducted in a large urban school district, in which the authors surveyed 55 clinicians within the special education system, with a focus on the mental health services provided to students who were receiving related-services counseling as a mandated component of their individualized education plan.…
Gabel, Jon; Pickreign, Jeremy; McDevitt, Roland; Briggs, Thomas
It's often assumed that high-cost health insurance plans--sometimes called "Cadillac" plans--provide rich benefits to plan subscribers. Health reform provisions that treat these plans like luxuries may be misguided. Only 3.7 percent of variation in the cost of family coverage can be explained by benefit design (actuarial value). Benefit design plus plan type (HMO, PPO, POS, or high-deductible plans) explains 6.1 percent of this variation. Industry type and medical costs in the region also play a role. Most variation in premiums, however, remains largely unexplained.
Integrated community case management and community-based health planning and services: a cross sectional study on the effectiveness of the national implementation for the treatment of malaria, diarrhoea and pneumonia.
Ferrer, Blanca Escribano; Webster, Jayne; Bruce, Jane; Narh-Bana, Solomon A; Narh, Clement T; Allotey, Naa-KorKor; Glover, Roland; Bart-Plange, Constance; Sagoe-Moses, Isabella; Malm, Keziah; Gyapong, Margaret
Ghana has developed two main community-based strategies that aim to increase access to quality treatment for malaria, diarrhoea and pneumonia: the Home-based Care (HBC) and the Community-based Health Planning and Services (CHPS). The objective was to assess the effectiveness of HBC and CHPS on utilization, appropriate treatment given and users' satisfaction for the treatment of malaria, diarrhoea and pneumonia. A household survey was conducted 2 and 8 years after implementation of HBC in the Volta and Northern Regions of Ghana, respectively. The study population was carers of children under-five who had fever, diarrhoea and/or cough in the last 2 weeks prior to the interview. HBC and CHPS utilization were assessed based on treatment-seeking behaviour when the child was sick. Appropriate treatment was based on adherence to national guidelines and satisfaction was based on the perceptions of the carers after the treatment-seeking visit. HBC utilization was 17.3 and 1.0 % in the Volta and Northern Regions respectively, while CHPS utilization in the same regions was 11.8 and 31.3 %, with large variation among districts. Regarding appropriate treatment of uncomplicated malaria, 36.7 % (n = 17) and 19.4 % (n = 1) of malaria cases were treated with ACT under the HBC in the Volta and Northern Regions respectively, and 14.7 % (n = 7) and 7.4 % (n = 26) under the CHPS in the Volta and Northern Regions. Regarding diarrhoea, 7.6 % (n = 4) of the children diagnosed with diarrhoea received oral rehydration salts (ORS) or were referred under the HBC in the Volta Region and 22.1 % (n = 6) and 5.6 % (n = 8) under the CHPS in the Volta and Northern Regions. Regarding suspected pneumonia, CHPS in the Northern Region gave the most appropriate treatment with 33.0 % (n = 4) of suspected cases receiving amoxicillin. Users of CHPS in the Volta Region were the most satisfied (97.7 % were satisfied or very satisfied) when compared with those of the HBC and of
Vannelli, Alberto; Buongiorno, Massimo; Zanardo, Michele; Basilico, Valerio; Capriata, Giulio; Rossi, Fabrizio; Pruiti, Vincenzo; Battaglia, Luigi
On December 23 of 1978, during first Italian recession since the end of World War II, Parliament voted for Law 833 that gives birth to the Italian National Public Health Services (SSN) as the new and alternative model of health care system. It was the beginning of the match of Italian health care with the world class level of the public health care. Each crisis requires solidarity and actions. Maintaining levels of health and other social expenditures is critical to protect life and livelihood and to boost productivity. The purpose of the present study is to establish an alternative point of view to demonstrate that Gross Domestic Product, is a function of health care expenditure. The chronology of the events was created by using the laws published on "Gazzetta Ufficiale" (GU). In order to analyze the corporate effectiveness and efficiency, we have divided the SSN into its three main components, namely resources (input), services (output) and performances (outcome). Health services have certainly been pioneers and are still today standard-bearers of a challenge which has borne its fruits. According to the "Organization for Economic Co-operation and Development", SSN ranks second in the world classification of the return on the health care services in 2000. The World Health Organization has published in 2005 the same result: SSN ranks second in the world for ability and quality of the health care in relationship to the resources invested The continuous reforms of health care system introduced stability to the Italian system more than others countries. Success of SSN function rooted in the ability of system to adapt assuring mechanism of positive feed-back correction. In the future SSN, will required new set of reforms, such as redefinition of structures and mechanisms of governance, strategic plans, clinical administrations.
Soeung, Sann Chan; Grundy, John; Maynard, Jim; Brooks, Alan; Boreland, Marian; Sarak, Duong; Jenkinson, Karl; Biggs, Beverley-Ann
The expanded programme of immunization was established in Cambodia in 1986. In 2002, 67% of eligible children were immunized, despite significant health sector and macro-economic financial constraints. A financial sustainability planning process for immunization was introduced in 2002, in order to mobilize national and international resources in support of the achievement of child health objectives. The aim of this paper is to outline this process, describe its early impact as an advocacy tool and recommend additional strategies for mobilizing additional resources for health. The methods of financial sustainability planning are described, including the advocacy strategies that were applied. Analysis of financial sustainability planning results indicates rising programme costs associated with new vaccine introduction and new technologies. Despite this, the national programme has demonstrated important early successes in using financial sustainability planning to advocate for increased mobilization of national and international sources of funding for immunization. The national immunization programme nevertheless faces formidable system and financial challenges in the coming years associated with rising costs, potentially diminishing sources of international assistance, and the developing role of sub-national authorities in programme management and financing.
US Fish and Wildlife Service, Department of the Interior — This Intra-Service Section 7 evaluation for the 2004 Hunting Plan concurs that activities associated with the proposed Hunting Plan for Crescent Lake National...
minorities, constituting about 9 % of the total population of 5.5 millions. The Danish Welfare State can be characterised as ‘universal’, providing high quality social care and benefits to all members of the society. Overall, the Danish healthcare system is based on a free access system with equity...... interventions and individual activities by the few health workers with a special interest in the migrant health. TTT is an illustration of providing psychosocial services to ethnic minority youth and their families based on combination of citizen volunteer work with partly state funding. This mental health NGO...... focuses on different categories of societal exclusion: ageism, sexism as well as racism experienced by migrants, involving the minorities both in planning and evaluation. These practices justify my placing of Denmark in the middle position on a continuum on one end with “Top down” approach in Holland...
Garcia, Leila Posenato; Zanetti-Ramos, Betina Giehl
The subject of "health services waste" is controversial and widely discussed. Biosafety, the principles of which include safeguarding occupational health, community health, and environmental safety, is directly involved in the issue of medical waste management. There are controversies as to the risks posed by medical waste, as evidenced by diverging opinions among authors: some advocate severe approaches on the basis that medical waste is hazardous, while others contend that the potential for infection from medical waste is nonexistent. The Brazilian National Health Surveillance Agency (ANVISA) has published resolution RDC 33/2003 to standardize medical waste management nationwide. There is an evident need to implement biosafety procedures in this area, including heath care workers' training and provision of information to the general population.
Ryder, Nathan; McNulty, Anna M
Confidentiality concerns are often described as barriers to seeking sexual health care. There has been little research describing the relative importance of confidentiality to clients of sexual health clinics, and whether members of high-risk groups have greater concerns. This study aimed to determine the importance of confidentiality and anonymity to clients of a public sexual health clinic, and determine associations with gender and sexuality. A self-administered questionnaire was offered to consecutive new English-speaking clients in October and November 2007. Participants were asked to describe the reasons for presenting, likelihood of disclosing identifying information, and concern should specific people and agencies become aware of their attendance. Of 350 eligible clients, 270 (77%) participated in the survey. Expert care was included in the top three reasons for choosing a sexual health clinic rather than a general practitioner by over half of participants, while confidentiality and cost were each included in the top three reasons by one-third of respondents respectively. Over 90% of clients reported they were likely to give accurate identifying information to the clinic. Participants were comfortable with disclosure of information to other health-care workers but became increasingly unwilling for information to be shared with services not directly involved in their care. Overall there were few associations with gender or sexuality. Clients choose to attend our clinic for a variety of reasons, with confidentiality and anonymity being of lesser importance than competence and cost. Confidentiality is important to the majority of clients, whereas few desire anonymity. Most clients would accept information being shared with other health services, suggesting that confidentiality may not be a barrier to the use of electronic health records in sexual health clinics.
Liang, Bryan A.
Health care reform efforts in both the Clinton and Obama administrations have attempted to address college and university health. Yet, although the world of health care delivery has almost universally evolved to managed care, school health programs have not. In general, school-sponsored health plans do little to improve access and have adopted…
Connolly, J.M.; Sailer, S.J.; Anderson, D.A.
The Idaho National Engineering Laboratory`s (INEL`s) Sample Management Office (SMO) conducts a Performance Evaluation Program that ensures that data of known quality are supplied by the analytical. chemistry service organizations with which the INEL contracts. The Analytical Services Performance Evaluation Plan documents the routine monitoring and assessment of suppliers conducted by the SMO, and it describes the procedures that are followed to ensure that suppliers meet all appropriate requirements. Because high-quality analytical support is vital to the success of DOE Environmental Management programs at the INEL, the performance of organizations providing these services must be routinely monitored and assessed. Analytical disciplines for which performance is monitored include metals, organics, radiochemical, and miscellaneous classical analysis methods.
Full Text Available Product service system is a new-type production system with high-degree integration and overall optimization of product and service. The participation of suppliers in product service system development will greatly shorten the development cycle and enhance the production efficiency. The task planning of product design is one of the key phases of product service system development process, which mainly contains the design task decomposition and the design task allocation. Aiming at product service system product design, this article conducts the decomposition of design tasks, performs the recognition of coupling design task set, and realizes the structured modeling of design tasks. Outsourcing decision-making analysis is conducted on the design tasks obtained through decomposition process so as to confirm the design tasks that need the participation of suppliers. The allocation model of design tasks is constructed, and the suppliers that take part in product service system development are confirmed based on genetic algorithm. Taking the numerical control machine tool as an example, this article conducts the instance analysis and verifies the feasibility of the forenamed methods.
Patient protection and Affordable Care Act; data collection to support standards related to essential health benefits; recognition of entities for the accreditation of qualified health plans. Final rule.
This final rule establishes data collection standards necessary to implement aspects of section 1302 of the Patient Protection and Affordable Care Act (Affordable Care Act), which directs the Secretary of Health and Human Services to define essential health benefits. This final rule outlines the data on applicable plans to be collected from certain issuers to support the definition of essential health benefits. This final rule also establishes a process for the recognition of accrediting entities for purposes of certification of qualified health plans.
Mary-Louise Jung; Karla Loria
Mary-Louise Jung1, Karla Loria11Division of Industrial Marketing, e-Commerce and Logistics, Lulea University of Technology, SwedenObjective: To investigate older people’s acceptance of e-health services, in order to identify determinants of, and barriers to, their intention to use e-health.Method: Based on one of the best-established models of technology acceptance, Technology Acceptance Model (TAM), in-depth exploratory interviews with twelve individuals over 45 years of age and of...
Michie, Lucy; Cameron, Sharon T; Glasier, Anna
Abortion services should provide high-quality contraceptive care. The community sexual and reproductive health (SRH) services may be well placed to deliver more abortion care in the UK. We wished to determine the views of health professionals working in SRH regarding their attitudes towards providing more abortion services and also the views of staff within one community SRH centre in Scotland where a service providing early medical abortion (EMA) was due to commence. An anonymous questionnaire distributed to attendees at a UK SRH scientific meeting collected data on demographics, current practice of and attitude to abortion, and views on delivery of abortion services. An internet questionnaire distributed by e-mail to staff at a community SRH clinic in Scotland sought demographics, views regarding the planned introduction of an EMA service and willingness to participate in it. 165 questionnaires were completed out of 200 distributed at the scientific meeting (an 82% response rate). 128 (78%) respondents felt that abortion services were suited to community clinics and 115 (70%) stated that they would be willing to participate in them. 62/90 (69%) staff from the SRH clinic responded to the internet questionnaire. 44 (71%) felt the plan to introduce abortion services was a natural extension to services already offered and the same number would be willing to be involved in such a service. There is clear support amongst health professionals in community SRH in the UK towards greater participation in the provision of abortion care services.
LEENAARS, PEM; ROMBOUTS, R; KOK, G
This article examines choice for STD health services among patients suspecting a STD. A total of 825 patients who sought medical treatment at an STD clinic, a Family Planning Clinic or a General Practitioner participated in this study. Special STD clinics are not well known among patients visiting t
LEENAARS, PEM; ROMBOUTS, R; KOK, G
This article examines choice for STD health services among patients suspecting a STD. A total of 825 patients who sought medical treatment at an STD clinic, a Family Planning Clinic or a General Practitioner participated in this study. Special STD clinics are not well known among patients visiting
... AFFAIRS Health Services Research and Development Service Scientific Merit Review Board; Notice of Meeting... Committee Act) that various subcommittees of the Health Services Research and Development Service Scientific... health care delivery and management, and nursing research. Applications are reviewed for scientific and...
... AFFAIRS Health Services Research and Development Service Scientific Merit Review Board, Notice of Meeting... Committee Act) that various subcommittees of the Health Services Research and Development Service Scientific... health care delivery and management, and nursing research. Applications are reviewed for scientific and...
... AFFAIRS Health Services Research and Development Service Scientific Merit Review Board; Notice of Meeting..., Program Manager, Scientific Merit Review Board, Department of Veterans Affairs, Health Services Research.... App. 2, that the Centers of Innovation subcommittee of the Health Services Research and Development...
Full Text Available The literature on innovation suggests that projects are successful when rigorous project management is mixed judiciously with 'organic' development. This paper argues that organic growth can play a substantial role in the implementation of electronic services in healthcare settings. Evidence for organic growth is presented, based on a study of email use. Methods are presented for investigating email use in health service settings in the National Health Service (NHS in Bradford, England. Geographical information systems (GIS outputs and social network analyses are presented. The results demonstrate a fivefold increase in the use of email over a 13-month period, which is shown to be largely independent of the growth in the number of organisations using the network. They also demonstrate a marked increase in the complexity of the patterns of email use over the period.